Obsessive-Compulsive and Related Disorders

Vocabulary flashcards based on the clinical features, etiology, patterns, and treatments of Obsessive-Compulsive Disorder.

Obsessive-compulsive disorder (OCD)

A disorder characterized by a diverse group of symptoms including intrusive thoughts, rituals, preoccupations, and compulsions that cause severe distress and interfere with social and occupational functioning.

Obsession

A recurrent and intrusive mental event, such as a thought, feeling, idea, or sensation.

Compulsion

A conscious, standardized, and recurrent behavior—such as counting, checking, or avoiding—performed in an attempt to reduce anxiety associated with an obsession.

Ego-dystonic

A state in which behaviors or thoughts are experienced as unwanted or foreign to the individual's self-perception.

Lifetime Prevalence of OCD

The estimated rate of the disorder in the general population, which is consistently between $2\%$ and $3\%$, making it the fourth most common psychiatric diagnosis.

Mean Age of Onset for OCD

The average age when symptoms begin is about $20$ years, with men typically starting earlier at $19$ years and women at $22$ years.

Comorbidity in OCD

The co-occurrence of other mental disorders, such as Major Depressive Disorder (found in $67\%$ of OCD patients) and Social Phobia (found in $25\%$).

Serotonergic System Hypothesis

The theory that dysregulation of serotonin is involved in OCD symptoms, supported by findings that serotonergic drugs are more effective than other neurotransmitter agents.

5-HIAA

A serotonin metabolite found in cerebrospinal fluid; decreased concentrations have been reported after treatment with clomipramine.

Key Brain Regions in OCD

Neuroimaging indicates altered function in the neurocircuitry between the orbitofrontal cortex, caudate, and thalamus.

Genetic Concordance in OCD

The probability of disorder transmission, which is significantly higher in monozygotic twins compared to dizygotic twins.

Learning Theory: Obsessions

According to behaviorists, these are conditioned stimuli where a neutral stimulus becomes associated with anxiety through respondent conditioning.

Learning Theory: Compulsions

Learned active avoidance strategies that become fixed patterns because they successfully reduce the painful secondary drive of anxiety.

Psychoanalytic Theory: Anal Phase Regression

Freud's view that OCD results from a regression from the oedipal phase to the anal psychosexual stage, often triggered by threats to love or safety.

Ambivalence

The coexistence of opposing emotions, such as love and hate toward the same object, which can lead to paralyzing doubt and indecision in OCD patients.

Magical Thinking

A cognitive regression where an individual believes their thoughts alone can cause external events to occur, leading to a fear of having aggressive thoughts.

Insight (DSM-5 Specifiers)

A classification of the patient's awareness regarding their beliefs, ranging from good or fair insight to poor insight and absent insight/delusional beliefs.

Contamination Pattern

The most common OCD symptom pattern, affecting $45\%$ of adults, involving an obsession with germs or dirt followed by rituals like excessive washing.

Pathological Doubt Pattern

The second most common symptom pattern, affecting $42\%$ of adults, involving obsessions about safety or danger followed by checking compulsions.

Intrusive Thoughts Pattern

The third most common pattern, characterized by repetitious sexual or aggressive thoughts that are reprehensible to the patient, often without outward compulsions.

Symmetry and Precision Pattern

The fourth most common pattern, where a need for exactness leads to compulsions of slowness, such as taking hours to eat or shave.

SSRI Treatment for OCD

FDA-approved medications like fluoxetine, fluvoxamine, paroxetine, sertraline, and citalopram, which often require higher dosages for beneficial effects.

Clomipramine (Anafranil)

A highly selective tricyclic drug for serotonin reuptake and the first medication approved by the FDA for the treatment of OCD.

Exposure and Response Prevention

The principal behavioral approach for OCD, considered a treatment of choice, where patients are exposed to triggers but prevented from performing rituals.

Cingulotomy

A psychosurgical procedure involving the cingulum that may be used for severe, treatment-resistant, and debilitating cases of OCD.

PANDAS

Pediatric autoimmune neuropsychiatric disorders associated with streptococcus, linked to inflammation of the basal ganglia and emerging OCD symptoms.

Olfactory Reference Syndrome

A condition characterized by a false belief that one has a foul body odor not perceived by others, leading to repetitive body washing or changing clothes.