OCD & Related disorder Flashcards
(29 cards)
Which disorders are included in the chapter of Obsessive-Compulsive and Related Disorders in DSM-5?
A:
✔️ Obsessive-Compulsive Disorder (OCD)
✔️ Body Dysmorphic Disorder (BDD)
✔️ Hoarding Disorder (HD)
✔️ Trichotillomania (Hair-Pulling Disorder)
✔️ Excoriation (Skin-Picking) Disorder
🧠 All are characterized by repetitive, intrusive thoughts and/or behaviors
How do the thoughts in Obsessive-Compulsive Disorder (OCD) differ from those in other Obsessive-Compulsive and Related Disorders (OCRDs) in terms of patient perception?
A:
✔️ OCD thoughts are typically ego-dystonic — the patient sees them as intrusive, irrational, and distressing
✔️ In many OCRDs (e.g., Body Dysmorphic Disorder, Hoarding Disorder), thoughts are more ego-syntonic — the patient sees them as justified or reasonable
What are the clinical features of trichotillomania? 💇♀️
A:
✔️ A chronic disorder with repeated hair pulling
✔️ Often results in thinning or patchy hair loss
✔️ Linked to increased tension/stress before pulling, followed by relief or satisfaction afterward
What complications can arise from trichotillomania due to hair swallowing? ⚠️🍽️
A:
✔️ 35–40% of patients chew or swallow pulled hair
✔️ About one-third of these develop bezoars (hairballs) in the gastrointestinal tract
✔️ Bezoars can be fatal if untreated
What is the most common site affected in trichotillomania? 💇♀️
The scalp
Q: What are the core diagnostic features of Obsessive-Compulsive Disorder (OCD)? 🔁🧼🧠
A:
A diverse group of symptoms including:
* Intrusive thoughts (obsessions)
* Repetitive behaviors (compulsions)
✔️ Must have either obsessions, compulsions, or both
✔️ Obsessions and compulsions are ego-dystonic
✔️ Patients typically have good insight
What are the most common symptom patterns of obsessions and compulsions in OCD? 📋
A:
✔️ Common obsessions:
- Contamination 45%
- Doubt
- Intrusive obsessional thoughts
- Need for symmetry
✔️ Common compulsions:
- Checking 63%
- Washing
- Counting
What are common clinical patterns and challenges in diagnosing OCD? ⏱️📉
A:
✔️ In 50–70% of cases, symptoms begin after a stressful event
✔️ Patients often delay 5–10 years before seeking psychiatric care
How do compulsive acts in OCD affect anxiety levels? 🔄😰
A:
✔️ Compulsions are performed to reduce anxiety caused by obsessions, but they do not always succeed in relieving anxiety
✔️ Anxiety increases when the person resists performing the compulsion
✔️ This cycle contributes to the persistence of OCD symptoms
What are the epidemiological features and prognosis of trichotillomania? 📊👧
A:
✔️ chronic
✔️ 10x more common in females
✔️ An earlier onset form (< 6 years) exists, affects both sexes equally
✔️ Better prognosis when onset is before age 6
How does the course and prognosis of OCD relate to obsessional content? 🧩📈
OCD is typically chronic and may persist for decades without treatment
✔️ Only about 20% improve significantly without therapy
✔️ The obsessional content does not influence prognosis
What is the most effective treatment approach for a patient with OCD?
A:
✔️ A combination of:
* high dose of SSRI or clomipramine (first-line pharmacotherapy)
* CBT (especially Exposure and Response Prevention – ERP)
What are the FDA-approved SSRIs used as first-line treatment for OCD?
A:
✔️ Fluoxetine
✔️ Fluvoxamine
✔️ Paroxetine
✔️ Sertraline
✔️ Citalopram
❓ How does Conversion Disorder differ from Body Dysmorphic Disorder in terms of symptom presentation and concern?
A:
✔️ Conversion Disorder: Neurological symptoms (e.g., paralysis) that are medically unexplained
✔️ Often accompanied by la belle indifférence (lack of concern)
✔️ BDD: Appearance-related concern with emotional distress, not neurological symptoms
: What is the key difference between OCD obsessions and delusions
A:
✔️ In OCD, patients have preserved insight — they recognize that their obsessive thoughts are irrational and unwanted (ego-dystonic)
✔️ In delusions, patients lack insight about the delusion — they firmly believe false ideas to be true, with no awareness of their irrationality (ego-syntonic)
What are the core diagnostic features of Body Dysmorphic Disorder (BDD)? 🪞🧠
A:
✔️ Persistent preoccupation with perceived defects or flaws in physical appearance
✔️ Flaws are not observable or appear minor to others
✔️ Preoccupations lead to repetitive behaviors, such as:
* Mirror checking or avoidance
* Comparing appearance with others
* Camouflaging perceived flaws
✔️ Often associated with ideas or delusions of reference
Which body parts are most commonly involved in complaints by BDD patients?
✔️ Hair (63%)
✔️ Nose
✔️ Skin
✔️ Eyes
In which clinical settings is BDD most commonly encountered? 🏥
A:
✔️ General adult psychiatric inpatients
✔️ Cosmetic surgery clinics
✔️ Dermatology clinics
How can Body Dysmorphic Disorder be differentiated from Somatic Symptom Disorder?
BDD: Preoccupation with appearance or bodily flaw
✔️ Somatic Symptom Disorder: Focus on physical symptoms like pain or fatigue
📌 This patient has no physical symptom complaints — only body-image concern
How does Conversion Disorder differ from Body Dysmorphic Disorder in terms of symptom presentation and concern?
What are common behaviors and psychological symptoms seen in BDD patients? 🔍🧠
A:
✔️ Mirror checking or avoiding reflective surfaces
✔️ Attempting to hide or camouflage the perceived defect
✔️ Ideas or delusions of reference (belief that others are noticing or mocking the flaw)
What are the core psychological drivers behind the persistent difficulty discarding possessions in people with Hoarding Disorder (HD)?
A:
✔️ Fear of needing the item in the future (future utility belief)
✔️ Emotional attachment to possessions
✔️ Distorted beliefs about the importance or value of items
📌 These drive the hoarding behavior.
How do individuals with Hoarding Disorder typically perceive their hoarding behavior?
🚫 Most do not perceive their behavior as problematic.
📌 This poor insight can delay treatment or reduce compliance.
