wamss notes obsessive compulsive and related disorders

Question 1

obsessive compulsive disorder

Answer 1

OCD is an anxiety disorder, characterised by the presence of recurring intrusive & unwanted thoughts, images, or obsessions & repetitive compulsions
Pt does not like these compulsions or obsessions

Question 2

criteria for obsessive compulsive disorder

Answer 2

A. Presence of Obsessions, Compulsions or Both
B. Obsessions or compulsions are time consuming
C+D. Not the effects of a substance or other mental disorder

Question 3

obsessions

Answer 3

• Recurrent & persistent thoughts, urges or images experienced as unwanted or
  intrusive & in most cause anxiety or distress
• Pt attempts to ignore or supress the thoughts or to neutralise them with another
  action

Question 4

compulsions

Answer 4

• Repetitive behaviours or mental acts the pt feels driven to perform in response to an
  obsession or to rules that must be rigidly applied
• Behaviours or mental acts are aimed at reducing or preventing anxiety or distress or
  preventing some dreaded situation, however are not connected in a realistic way to
  prevent or are clearly excessive

Question 5

common compulsions

Answer 5

Checking, washing, contamination, doubting, bodily fears, counting, insistence on symmetry,
aggressive thoughts, list making, rearranging, touching objects

Question 6

risk factors for OCD

Answer 6

• Genetics
• Child abuse or stress
• In utero exposure to smoking, drugs, alcohol

Question 7

Tx for OCD

Answer 7

CBT, Behavioural therapy, cognitive therapy, psychotherapy
Behavioural management strategies
Parental educations
First Line:
- SSRI
Second Line:
- TCA (Clomipramine- serotonin receptor blocking action)

Question 8

prognosis of OCD

Answer 8

20-30% significant improvement
40-50% moderate improvement
20-40% chronic or worsening Sx
Relapse rates high after medication cessation

Question 9

body dysmorphic disorder

Answer 9

Obsessive preoccupation that some aspect of one’s own appearance is severely flawed and warrants exceptional measures to hide or fix it

Question 10

criteria for body dysmorphic disorder

Answer 10

Preoccupation with perceived defects or flaws that are not apparent or appear slight to others
Pt performs repetitive or mental acts in response to appearance concerns (mirror checking)
Preoccupation causes clinical distress of impaired functioning

Question 11

hoarding disorder

Answer 11

Pattern of behaviour that is characterized by excessive acquisition and an inability or
unwillingness to discard large quantities of objects that cover the living areas of the home and
cause significant distress or impairment

Question 12

criteria of hoarding disorder

Answer 12

Persistent difficulty parting with possessions regardless of their actual value
Results in accumulation of possessions that congest & clutter active living areas &
substantially compromises the intended use of the area
Significant distress or impairment in functioning

Question 13

trichotillomania

Answer 13

Recurrent pulling out of one’s own hair
- Redirecting behaviours (sits on hands, lacky bands)

Question 14

excoriation

Answer 14

Recurrent skin picking resulting in skin lesions