BMED-OCD

What is a typical OCD obsession?

Mind overwhelmed by constant, fixated fear or concern

How does an obsession affect emotion?

Provokes intense anxiety and distress

What is a compulsion in OCD?

Pattern of repetitive behavior or mental acts to reduce anxiety

Does compulsive behavior provide permanent or temporary relief?

Temporary; cycle repeats

What defines compulsions in OCD?

Repetitive behaviors/mental acts driven by an obsession or rigid rules

What is the goal of compulsions?

Reduce distress or prevent dreaded events, though not realistically connected or clearly excessive

What defines obsessions in OCD?

Recurrent, persistent, intrusive, and unwanted thoughts, urges, or images

How do individuals typically respond to obsessions?

Attempt to ignore/suppress or neutralize them with a compulsion

Match a common obsession with its usual compulsion: fear of contamination.

Obsession: contamination → Compulsion: washing, cleaning

Match: need for symmetry/"just right."

Obsession: symmetry → Compulsion: ordering, arranging, balancing, straightening

Match: unwanted sexual or aggressive thoughts/images.

Obsession: sexual/aggressive → Compulsions: checking, praying, "undoing," reassurance seeking

Match: doubts about things like stove or doors.

Obsession: doubt → Compulsion: repeated checking

Match: concern about discarding something valuable.

Obsession: discarding → Compulsion: hoarding

What social factor can trigger OCD onset?

Major stress or traumatic life event in predisposed person

How is depression related to OCD?

Can be symptom or cause; opinion split

What is OCD prevalence in general population?

About 2.6%

How does OCD sex distribution change over lifespan?

Males earlier onset; equal in mid-adolescence; more females in adulthood; overall majority female (~60%)

What proportion of normal college students show checking behavior at OCD range?

10-15%

Which neurotransmitter is central in OCD?

Serotonin

Name psychiatric differentials for OCD.

MDD, other anxiety disorders, eating disorders, substance-related disorders, Tourette's, GAD, phobias, schizophrenia

What is the course of OCD?

Chronic and cyclical, but most improve with treatment

What is standard therapy for OCD?

Medications (SSRIs, TCAs, atypical antipsychotics, benzos) plus CBT

What is the basic definition of BDD?

Preoccupation with imagined defect or disproportionate concern about slight anomaly

What does DSM say about the appearance concern in BDD?

Perceived defects not observable or appear slight to others

What behavior or mental acts are required in BDD?

Repetitive behaviors or mental acts in response to appearance concerns

What is muscle dysmorphia?

Preoccupation with belief body build is too small or insufficiently muscular

When is the muscle dysmorphia specifier used?

Even if other body areas are also preoccupations

What is the prevalence of BDD in the general population?

0.7-2.4%

Name etiologic factors in BDD.

Heredity and whole-brain structural topologic disturbances

Name some differential diagnoses for BDD.

Anorexia, anxiety, social phobia, selective mutism, bipolar, conversion disorder, delusional disorder, depression, OCD, schizophrenia, somatoform disorders

What is main therapy for BDD?

Combination of CBT and medications

What is the core definition of Hoarding Disorder?

Persistent difficulty discarding or parting with possessions regardless of value

Why do people with Hoarding Disorder avoid discarding possessions?

Perceived need to save items and distress over discarding

What happens to living areas in Hoarding Disorder?

Cluttered and congested, compromising intended use

When are living areas only uncluttered in Hoarding Disorder?

Due to interventions of third parties

What is the "with excessive acquisition" specifier in Hoarding Disorder?

Difficulty discarding plus excessive acquisition of unnecessary items

What aspect of Hoarding is often described under "insight"?

Degree to which the person recognizes the hoarding as a problem

What is the prevalence of Hoarding Disorder?

About 1.5%

What is known about the etiology of Hoarding Disorder?

Unknown

How do people with Hoarding Disorder typically perceive their behavior?

Often lack insight

Who usually urges them to seek help?

Relatives

Name some differentials for Hoarding Disorder.

Alcohol-related psychosis, Alzheimer's, autism, depression, intellectual disability, OCD, schizophrenia

What is primary treatment for Hoarding Disorder?

Psychotherapy

What is Trichotillomania?

Recurrent pulling out of one's hair resulting in hair loss

What is required about attempts to reduce Trichotillomania?

Repeated attempts to decrease or stop hair pulling

What is Excoriation Disorder?

Recurrent skin picking resulting in skin lesions

What is required about attempts to reduce Excoriation Disorder?

Repeated attempts to decrease or stop skin picking

Name related body-focused repetitive behavior conditions.

Body dysmorphic-like disorder with actual flaws, BDD-like disorder without repetitive behaviors, body-focused repetitive behavior disorder, obsessional jealousy