Flashcards in OCD Deck (38):
intrusive thoughts (obsessions) producing anxiety leading to REPETITIVE behaviors engaged in to reduce anxiety
OCD - comorbidities?
another anxiety disorder
-abnormal activity in brain circuit recruitment during cognitive tasks
-abnormal serotoninergic and dopaminergic signaling
post group a strep
OCD - sx?
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
Obsessive compulsive personality disorder?
very hard to tx
rigid control that leads to ritualized behavior
OCD- DSM V dx?
obsession, compulsion, both
obsessions, compulsions are time consuming or x significant distress or impairment in social, occupation, and other fxns
-exposure and response prevention (expose the pt to the obsession/trigger --> replace negative compulsion w/ positive)
-acceptance and commitment therapy
-first line: SSRI
-second line: TCA
-third lien: SNRI
OCD - prognosis?
SSRI stopped abruptly?
flu like sx
dries everything - mouth, south
persistent difficulty discarding or parting w/ possessions REGARDLESS OF THEIR ACTUAL VALUE
Hoarding disorder - 3 components?
1) collecting too many items
2) difficulty getting rid of items
3) probs w/ organization
-processing of reward value
Hoarding - regions of the brain that is affected?
-ventromedial prefrontal cortex
-anterior cingulate cortex
"this bottle cap is the only one ive seen"
"if i throw bottle cap away - something bad will happen"
inability to throw away possession
anxiety when tempted to discard items
indecisive whether to keep or where to put things
suspicions of other people touching items
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
Hoarding - comorbidites?
General anxiety disorder
pulling hair - ANYWHERE THAT HAS HAIR
Trichotillomania - warning signs?
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
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
education: hair pulling barriers
2) meds: SSRI
3) alternative therapies: N-acetylcysteine
skin and hair pulling
skin picking by recurrent skin picking resulting in SKIN LESION
-dig into skin
*belief that bug is under skin
1) injury or disease of the skin
2) stressful life experience (outlet of the emotions)
-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
-CBC (cancer, anemia)
substance abuse (opiate withdrawal)
-oral, topical (lidocaine)
-barriers (una sleeves)
Interviewing the pt?
Smile and sit squarely
Open body posture