OCD

Question 1

OCD risk factors

Answer 1

fam history
peak age = 10-20yrs

pregnancy/postnatal period
hx of abuse, bullying, neglect

Question 2

scale/score used in OCD

Answer 2

Y-BOCS
-> classifies impairment into mild, moderate or severe

Question 3

mx of mild OCD

Answer 3

CBT including exposure + response prevention (ERP)

• if insufficient/can’t engae in psychological therapy -> offer SSRI or more intensive CBT + ERP

Question 4

mx of moderate OCD

Answer 4

SSRI or intensive CBT + ERP

• consider clomipramine as alternative to SSRI if patient prefers/ SSRI contraindicated

Question 5

mx of severe functional impairing OCD

Answer 5

refer to secondary care mental health for assessment

whilst waiting, offer;
- combined treatment with SSRI + CBT incl ERP

Question 6

OCD vs depression mx with SSRI

Answer 6

OCD, if effective then continue for at least 12 months

• compared to depression, SSRI usually requires higher dose + longer duration of treatment (At least 12wks) for an initial response