Obsessive Compulsive and Related Disorders Exam Questions and Solutions
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Course
Obsessive Compulsive Disorder
Institution
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder: DSM V criteria A. Presence of obsessions, compulsions, or both B. Obsessions/compulsions are time consuming (>1hr/day) or cause clinically significant distress C. Sx not due to substance abuse or other medical conditions D. Not due to another medical disorder *Spec...
Obsessive Compulsive and Related
Disorders Exam Questions and
Solutions
Obsessive Compulsive Disorder: DSM V criteria ✅A. Presence of obsessions,
compulsions, or both
B. Obsessions/compulsions are time consuming (>1hr/day) or cause clinically significant
distress
C. Sx not due to substance abuse or other medical conditions
D. Not due to another medical disorder
*Specify degree of insight: good/fair, poor, absent
Obsessive Compulsive disorder: Obsessions ✅1. Recurrent and persistent thoughts,
urges, or images experienced as intrusive and unwanted and that most individuals
cause marked anxiety
2. Individual tries to ignore or suppress the thoughts/urges/images or neutralizes them
with other thoughts/actions -> rituals
*Not merely worries about real life problems. Efforts to ignore the thoughts/impulses is
tried by failed. Individuals know the thoughts are their own
Obsessive Compulsive disorder: Compulsions ✅1. Repetitive behaviors that the
individual feels driven to perform in response to an obsession or rules that must be
applied rigidly
2. Behaviors/mental acts aimed at preventing or reducing anxiety or distress or
preventing a dreaded event or situation however they are not connected in a realistic
way with what they are designed to neutralize
OCD Epidemiology ✅1-3% of general population
Mean age of onset is 22 - any age by usually late teens/early twenties, most by 30
Men = women
1/200 children
Compulsions ✅75-95% have compulsions and obsessions
Obsessions = thoughts
Compulsions = behaviors
Usually strong desire to resist, only about 50% actually do
Cause marked distress/time consuming
Interferes with normal routine, occupation or school function
Four major patterns of OCD ✅Obsession -> Compulsion
Contamination -> Washing/avoid
, Pathologic doubt -> Checking
Intrusive thoughts -> None
Symmetry -> arranging/ordering
Hoarding also common
OCD Treatment ✅SSRI, TCA
Expect 3-4 mo to see benefit
40% do not respond to SSRI
Relapse>treatment of depression
OCD Treatment: Behavioral therapy ✅Best success with rituals
Almost all pt's do well
Behavioral analysis to look at: target behaviors, exposure, response prevention
OCD Comorbidities ✅DEPRESSION
Anxiety/eating/substance disorders
Tourette's Syndrome (40-90% have obsessions and compulsions)
Trichotillomania (hair pulling)
Body Dysmorphic Disorder: DSM V ✅A. Preoccupation with one or more percieved
defects or flaws in physical appearance that are not observable or appear to others
B. The individual has performed repetitive behaviors over the course of the disorder -
mirror checking, excessive grooming, skin picking
C. Causes clinically significant distress
D. Not better explained by a preoccupation with fat in a pt who meets the criteria for an
eating disorder
Body Dysmorphic Disorder: Mirror gazing ✅Most common repetitive behavior (80%)
Most disgusted by their appearance
Some try to hide by looking at a spoon
Uses mirror to compare 3 different images - what they say in the mirror, what they
perceived as ideal images of themselves, distorted images of themselves
Body Dysmorphic Disorder: Other manifestations ✅Compulsive skin picking (27%):
Some use knives
Most camouflage appearance in public
Some will push their noses, skin etc to try and get it to appear better
Body Dysmorphic Disorder: DDX ✅Social phobia - isolation
Histrionic personality
Illness anxiety disorder
Major depression
Schizophrenia
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