OCD Flashcards Preview

Behavioral Med > OCD > Flashcards

Flashcards in OCD Deck (38):
0

OCD?

intrusive thoughts (obsessions) producing anxiety leading to REPETITIVE behaviors engaged in to reduce anxiety

1

OCD - comorbidities?

another anxiety disorder
mood disorder
tic disorder
bipolar
eating
tourettes
MDD
generalized anxiety
social anxiety

2

OCD- pathogenesis?

neurobiology
-abnormal activity in brain circuit recruitment during cognitive tasks
-abnormal serotoninergic and dopaminergic signaling
genetics
post group a strep
premenstrual
postpartum
stroke
traumatic event
TBI

3

OCD - sx?

obsessions:
-dirt/contamination
-hoarding/saving
-sexual content
-superstitious fears

4

Getting to the dx of OCD?

ask specific questions about intrusive thoughts, urges, images about repetitive behaviors and mental rituals
document frequency (acute/chronic), amount of time used, extent of actions that interferes w/ADLs

5

Obsessive compulsive personality disorder?

very hard to tx
excessive perfectionism
rigid control that leads to ritualized behavior

6

OCD- DSM V dx?

obsession, compulsion, both
obsessions, compulsions are time consuming or x significant distress or impairment in social, occupation, and other fxns

7

OCD tx?

CBT
-exposure and response prevention (expose the pt to the obsession/trigger --> replace negative compulsion w/ positive)
-acceptance and commitment therapy
meds
-first line: SSRI
-second line: TCA
-third lien: SNRI

8

OCD - prognosis?

70-80% recovery

9

SSRI ADR?

sexual dysfxn

10

SSRI stopped abruptly?

flu like sx

11

TCA ADR?

dries everything - mouth, south

12

Hoarding disorder?

persistent difficulty discarding or parting w/ possessions REGARDLESS OF THEIR ACTUAL VALUE

13

Hoarding disorder - 3 components?

1) collecting too many items
2) difficulty getting rid of items
3) probs w/ organization

14

Hoarding-trigger?

TBI
glucose metabolism
neuroimaging:
-executive fxning
-impulse control
-processing of reward value

15

Hoarding - regions of the brain that is affected?

frontal lobe
-orbitofrontal cortex
-ventromedial prefrontal cortex
-anterior cingulate cortex

16

"this bottle cap is the only one ive seen"

hoarding

17

"if i throw bottle cap away - something bad will happen"

ocd

18

Hoarding sx?

inability to throw away possession
anxiety when tempted to discard items
cannot categorize
indecisive whether to keep or where to put things
suspicions of other people touching items

19

Hoarding - DSM V?

persistent difficulty discarding or parting w/ personal possession - even though its not important
effects: social, occupational, other imp areas - not safe
sx are NOT d/t brain injury, CV dz

20

Hoarding - comorbidites?

MDD
General anxiety disorder
social phobia
PTSD
ADHD
grooming disorder
dementia

21

Hoarding tx?

CBT
-motivation interviewing
+/- meds
-SSRI/SNRI
TCA

22

Trichotillomania?

pulling hair - ANYWHERE THAT HAS HAIR

23

Trichotillomania - warning signs?

wearing hats
wearing excessive eye make up or glasses
continually playing w/ one's hair
preoccupation, anxiety, depression
avoidance of windy/wet situations
career or academic decline

24

Trichotillomania - DSM 5?

irresistible hair pulling and has hair loss
repeated attempts to decrease or stop hair pulling
hair pulling cxs clinically significant distress or impairment in social, occupational, or other areas of fxning
hair pulling/loss is NOT d/t o another attribute
unconscious; emotionally driven

25

Trichotillomania tx?

education: hair pulling barriers
1) CBT
2) meds: SSRI
3) alternative therapies: N-acetylcysteine
support groups

26

Dematillomania?

skin and hair pulling

27

Dermatophagia?

scab eating

28

Dermaphagia?

eating hair

29

Excoriation (SPD)?

skin picking by recurrent skin picking resulting in SKIN LESION
-repetitively touch
-rub
-scratching
-pick
-dig into skin
*belief that bug is under skin

30

Excoriation cx?

1) injury or disease of the skin
2) stressful life experience (outlet of the emotions)

31

Excoriation- dx?

-repeated attempts to decrease or stop the skin picking
-cx clinically significant distress or impairment in social, occupational or other important areas of fxning
-sx must not be better explained by sx of another mental or medical disorder

32

Excoriation investigation?

labs:
-CBC (cancer, anemia)
-Chemistry panel
-TSH
-FBG (diabetes)
-ANA (autoimmune)
-ESR (autoimmune)
Imaging:
-CXR (lymphoma)

33

Excoration DDx?

dermatological disorder
autoimmune probs
BDD
OCD
substance abuse (opiate withdrawal)
autism
psychosis

34

Excoriatiotn tx?

CBT
meds:
-oral, topical (lidocaine)
-barriers (una sleeves)

35

Interviewing the pt?

SOLER
OARS

36

SOLER?

Smile and sit squarely
Open body posture
Lean slightly
Eye contact
Relax

37

OARS?

Open-ended questions
Affirmations
Reflective listening
Summaries