OCD 6.2

OCD

Obessive compulsive disorder: persistant unwanted, intrusive thoughts, and compulsions, repetitive actions to supress them

OCD commobidity

it is not uncommon for ocd to come along with extreme GAD, panic attacks, major depression, extreme avoidance since they all occur in OCD

OCD clinical description

the anxiety is focused on a thought, image, that the client want to avoid completely.

if you work so hard to supress something all mental capacities go towards that you will not be able to focus on anyhting else

Obessions

intrusive nonsensical images,urges, thoughts which the person wants to get rid of or resist

Compulsions

thoughts or actions used to relieve the obessions / supress

can be behavioural (hand washing, checking)

or thoughts (thinking of something spelled backwards, counting, praying)

no logical relation to obession

Diagnostic Criteria for OCD Obessions

reoccurant persistant thoughts, urges, or images that are unwanted, intrude in mind which cause anxiety or stress

indivual tries to supress with a neutralizing action or ignore

Diagnostic Criteria for OCD Compulsions

Repetitive behaviours or mental acts which the person feels the need to perform in response to obessions or according to rules

behaviours or mental acts have no logical connection to the obession but are done to prevent a dreaded event from happening or reduce stress of obessions

Diagnostic Criteria for OCD rest

obessions and compulsions are time consuming

(longer than an 1/day)

significant distress or impariment in school, occupation, social

cant be contributed to a substance

not better explained by another disorder

specify the individuals insight: 

good: obessions prob not true

poor: prob true

absent: delusional has no doubt

specify if tic related

4 major types of OCD obessions

Symmetry/just right:

Forbidden thoughts or actions:

Cleaning/contamination:

Symmetry/just right:

needs things perfectly aligned, will do things over and over until perfect to them

a quarter of all OCD

compulsions:

putting things in certain order

repeating rituals

Forbidden thoughts or actions:

harming self or others, offending god

a quarter of all ocd

compulsions:

checking (prevents imagined diaster), avoidance, askng for reassurance

Cleaning/contamination:

fear of germs and contamination of germs

15 percent of all ocd

another 15 is hoarding

compulsions:

excessive washing, and so on

Tic Disorder and OCD

commonly occur together

tics almost always related to symmtry

in children co occurs 10-40%

and tics can be different from jerking compulsions

PANS

ocd and tics develop after strep throat

OCD prev

lifetime prevelance 2% of ocd

after a year it goes up to 1%

in children more male but basically equal

world wide 1% but slightly higher in women than men

OCD onset

15 yrs old early adolesnce to mid twenties

peakng earlier in males than females

OCD culturally

looks similarsame across different countries. more reglious in arab countires, and cleaning is prev in india

OCD Causes

intrusive thoughts regulated by brain circuit tho same general precursors as anxiety

why is OCD anxiety focused on obessions: hypothesis

early life epxeriences taught them that certrain thoughts were unacceptable or dangerous

resulting in specifc psyc vulnerablity for OCD

thought action fusion

equating thoughts with certain action or activies represented by the thoughts

caused by excessive resobility for thougths and guilt in childhood

OCD Treatment

SSRI effective ebenfiting up to 60% but relapse imminet when discontinued

highly structured psy tratemtnts work better but not readily available. exposure and ritual prevention. prevent the ritual so they have to endure thoughts/obesons

ERP exposure response prevention most effective try after after SSRI

Psychosurgery 1/3 benefit greatly

cingulate surgery some get adverse side effects