Obsessive Compulsive and Related Disorders

Obsessions

Excessive, unwanted, intrusive, and persistent thoughts, impulses, or images causing anxiety and distress

Compulsions

Repetitive behaviors performed in a ritualistic fashion

What is the goal of compulsions?

Preventing or reliving anxiety and distress caused by obsessions

What is the most common obsession?

Contamination

What is something to prioritize in a patient who compulsively hand washes?

A skin assessment

When doing an assessment on a patient with OCD, what should the nurse establish?

The patient’s obsessions and compulsions, what their coping mechanisms are, and how their OCD affects their everyday life

What class of medication is given for patients with OCD?

SSRIs. Can take 6-8 weeks to work, so must be honest with the patient

Trichotillomania

Chronic self-destructive hair pulling that results in noticeable hair loss. The individual had an increase in tension immediately before pulling out the hair, and feels relief when the hair is pulled out

Trichobezoar

Ingested hair ball seen in Trichotillomania. May cause anorexia, stomach pain, anemia, intestinal obstruction, and peritonitis

Excoriation Disorder

Repetitive and compulsive picking of skin causing tissue damage. May be tall over the body or isolated to one spot. Skin assessment is imperative

Body Dysmorphic Disorder

Focus on real (but slight) or imagined defects in appearance. Preoccupation with the perceived defect causes significant distress and interferes with ability to function socially

Hoarding Disorder

Difficulty parting with or discarding possessions, regardless of actual value. Can create public health and/or safety risks; hame safety may be compromised