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Obsessive Compulsive Disorder (OCD). AHMAD ALHADI, MD Psychiatrist and Psychotherapist KSU, KKUH. O C D. Irresistible, Compelling Actions or mental acts Done in response to obsessions or according to rules …to reduce anxiety or prevent dreaded events or situations e.g. washing hands

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obsessive compulsive disorder ocd

Obsessive Compulsive Disorder (OCD)

AHMAD ALHADI, MD

Psychiatrist and Psychotherapist

KSU, KKUH

o c d
OCD

Irresistible, Compelling

Actions or mental

acts

Done in response to obsessions or according to rules …to reduce anxiety or prevent dreaded events or situations

e.g. washing hands

repeatedly

Compulsions

Own: thoughts,

Impulses, images

Intrusive, Insisting,Unwanted

Repetitive

Irrational

e.g. contaminated hands

  • Time–consuming
  • at least 1 h/ d
  • Functioning imp.

Disorder

Obsessions

main themes of ocd
Main themes of OCD

**** sense of danger and/or responsibility.

  • Contamination  washing.
  • Pathological doubts  checking, e.g. repeating Ablution, prayers.
  • Intrusive thoughts (sexual or aggressive acts, divorce) mental acts
  • Symmetry  slowness
  • Hoarding
associated features
Associated features
  • Excessive self blame & sense of responsibility
  • Feeling anxious OCD
  • Depressive feeling  OCD
  • OCPD
epidemiology
Epidemiology

Males = Females

Lifetime prevalence = 2-3 %

Mean age of onset = 20 – 25 years

etiology
Etiology
  • Serotonin
  • Genetic predisposition - ? OCPD
  • Debate about religious factors
changes in cerebral glucose metabolic rate after treatment of obsessive compulsive disorder
Changes in Cerebral Glucose Metabolic Rate after Treatment of Obsessive-Compulsive Disorder

The PET scans show decreases in glucose metabolic activity in the orbitofrontal cortex and right caudate after both the behavioural therapy sessions and the

Fluoxetine treatment.

Jeffrey M, 1996

d d x
D D x
  • Anxiety, panic and phobia.
  • Depressive disorders.
  • Hypochondriasis
  • Schizophrenia.
  • Organic mental disorders e.g. PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections)
  • OCPD: perfectionism, orderliness …
course
Course

Gradual > acute

Chronic

Waxing & waning

prognosis
Prognosis
  • Non – severe
  • No OCPD
  • Depressed / anxious mood
  • Compliance with Tx
  • Family support

Good p. Factors

treatment
Treatment

Pharmaco-behavioral:

  • Pharmacological:
    • SSRIs : Fluoxetine - Paroxetine
    • Clomipramine
  • Behavioral: exposure & response prevention
  • Others
ad