Please enable JavaScript.
Coggle requires JavaScript to display documents.
OBSESSIVE COMPULSIVE DISORDER, LO1, LO2, LO3, LO4, ANASTASIA CHELSEA ANAK…
OBSESSIVE COMPULSIVE DISORDER
DEFINITION (based on DSM-5)
characterized by the presence of obsessions &/ compulsions.
obsessions = recurrent & persistent thoughts, urges, or images that are experienced as intrusive & unwanted
compulsions = repetitive behaviors / mental acts that an individual feels driven to perform in response to an obsession / according to rules that must be applied rigidly.
PREVALENCE
12 mth prevalence = US : 1.2%
gender : females slightly higher rate than males (adulthood)
internationally : 1.1% - 1.8%
DEVELOPMENT & COURSE
onset on childhood / adolescence = could lead to lifetime OCD
w/o tx = remission rates in adults are low
episodic course (some indvdl)
deteriorating course (minority)
if untreated, course usually chronic
often with waxing and waning sx
onset of sx = typically gradual
but, acute onset has also been reported
males = has earlier onset than females
nearly 25% (males) has onset before 10 y/o
onset after35 y/o = unusual (but does occur)
mean age at onset = 19.5 y/o
25% starts by the age of 14 y/o
ETIOLOGY
TEMPERAMENTAL
Possible risk factors :
greater internalizing sx
higher -ve emotionality
behavioral inhibition in childhood
ENVIRONMENTAL
increased risk of developing OCD :
physical & sexual abuse in childhood
other stressful/ traumatic events
GENETIC & PHYSIOLOGICAL
rate of OCD among first-degree relatives of adults w OCD = approx. 2x that among first-degree relatives of those w/o the disorder
PATHOPHYSIOLOGY
Familial transmission is due in part to genetic factors
(e.g., a concordance rate of 0.57 for monozygotic vs. 0.22 for dizygotic twins).
Dysfx in orbitofrontal cortex, anterior cingulate cortex, & striatum = most strongly implicated
CLASSIFICATION OF OCD
body dysmorphic disorder
hoarding disorder
Trichotillomania (hair pulling)
Exocriation (skin-picking)
substance/medication induced OCD and related disease
OCD & related disorder d/t another medical condition
other specified/ unspecified OCD & related disorder
SIGN & SYMPTOMS
common OCD obsession
fear of contamination & dirt
doubting & have difficulty tolerating uncertainty
needing things orderly & symmetrical
aggressive/ horrific thoughts (abt losing ctrl & harming self/others)
unwanted thoughts (incldg aggression/sexual/religioys subjects)
DIAGNOSIS
Diagnostic Feature
Obsessions are repetitive and persistent thoughts, images, or urges
not pleasurable/experienced as voluntary (intrusive & unwanted & caused marked distress/anxiety in most individual)
indvdl attempts to ignore/suppress those obsessions/ neutralize them w/ another thought/actions.
severity of OCD
Vary across indvdl
eg: some have mild-mod sx, spending 1-3hrs per day obsessing/doing compulsions....
Associated feature
indvdl experience a range of affective responses when confronted w/ situations that trigger obsessions & compulsions
eg: many experience marked anxiety that can include recurrent panic attacks, other reports strong feelings & disgust
avoidance behavior : common for indvdl w disorder to avoid ppl/places/things that trigger obsessions & compulsions
Comorbidity
-MDD = most common comorbid disorder, w/ onset after that of body dysmorphic disorder
comorbid social anxiety disorder, OCD, & substance-related disorder r also common.
MEDICAL MX
Medications - antidepressants
psychotherapy - CBT
PROGNOSIS
OCD = chronic condition w/ a low rate of spontaneous remission
left untreated = sx &fxnal impairment fluctuate, w/ worsening during periods of > life stress
w/ tx = > rates of sx remission. full recovery (however is the exception rather than the rule).
LO1
LO2
LO3
LO4
ANASTASIA CHELSEA ANAK EDWARD EFFANDY
(DPOT1/2021(07)-0002)
