Obsessive Compulsive Disorder

No added benefit from combined treatment of

CBT with drugs

Cognitive-behavioral therapy

Exposure and ritual prevention (ERP)

One study found that 86% of patients benefit from

CBT

SSRIs have what percentage of benefit?

60%

When discontinued, SSRIs have

high relapse

Psychosurgery has what percentage of benefit?

30%

Causes of OCD

Similar generalized biological vulnerability to having anxiety in general

Specific psychological vulnerability

Early life experiences and learning

Thoughts are dangerous/unacceptable

Thought-action fusion

Distraction temporarily

reduces anxiety

Distraction increases

frequency of thought

Onset

childhood to 30s

Tic disorder

Involuntary movements (e.g. sudden jerking of limbs, movement of jaw, etc)

Tic disorder often co-occurs in

patients with OCD

Sometimes tics are used as compulsive behaviors –performed to

relieve anxiety associated with obsessions

4 major categories of compulsions

Checking

Ordering

Arranging

Washing/cleaning

60% of people suffering from OCD

have multiple obsessions

Obsessions: need for

symmetry

Obsessions: Forbidden

thoughts or actions

Obsessions: Cleaning and

contamination

Diagnostic Criteria: Presence of

obsessions, compulsions, or both

Diagnostic Criteria: Obsessions/compulsions are

time-consuming

Diagnostic Criteria: Disturbance is not due to

substance abuse

Diagnostic Criteria: Disturbance not better explained by

another mental health disorder

Clinical description of obsessions:

Intrusive and nonsensical

Thoughts, images, or urges

Attempts to resist or eliminate

Clinical description of obsessions:

Thoughts or actions

Provide relief from obsessive thoughts