Transcript Obsessive Compulsive Disorder

Obsessive Compulsive
Disorder
By: Alexa Van Bergen, Nathan
Northcutt, Enrique Barajas, Sandy
Fisher, Andrew Crist
What is OCD?
● Characterized by Obsessions and
Compulsions
● Obsessions
- recurrent and persistent thoughts, urges or images
- the individual attempts to suppress them with
another thought or action
What is OCD?
● Compulsions
- Repetitive behaviors that the individual feels
compelled to perform
- Aimed at reducing anxiety, distress or preventing a
dreaded situation
● Must be time consuming and cause clinically
significant impairment and distress
Who has OCD?
● 1.2% of Americans have OCD.
● Onset in later teens early 20s.
● Women more than men, vice versa in
childhood.
● 40% experience remission if diagnosed in
childhood.
Causes of OCD
Specific cause not yet discovered
Various theories
1. Biological
2. Environmental
3. Temperamental
*Combination of all
Causes of OCD: Biological
● Problems in communication between the front part of the brain and
deeper structures of the brain
● “Leaky filter” in basal ganglia
-possibly caused by Group A streptococcal infections
Causes of OCD: Biological
● Neurochemical imbalances
-low levels of serotonin
-medications that affect serotonin
“normalize” brain circuits
● Caudate nucleus (overactivity)
-brain region that controls habits
● Runs in families
-no specific gene
Causes of OCD:Environmental
How risk for OCD increases
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Physical/sexual abuse in childhood
Various infectious agents
Postinfectious autoimmune syndrome
Other stressful or traumatic events
Causes of OCD:Temperamental
Possible risk factors:
1. Greater internalizing symptoms
2. Higher negative emotionality
3. Behavior inhibition in childhood
Behaviors
Obsessions lead to compulsions
-Examples: obsession with orderliness can cause someone
to arrange their canned goods to face a certain way
Compulsions depend on whatever the person is fixated on
and are irresistible urges to behave in a certain way.
Behaviors
Behaviors are performed to relieve anxiety
These behaviors impact everyday life
● Lengthy rituals can lead to tardiness
● Some rituals can be harmful
-washing hands until they are raw
Living with OCD
- avalanche of intrusive images, or actions
invading the conscious mind
- the obsessions are outside what the person
can control.
- people with OCD don’t like the way that
the word obsessed is used today
Continued.
- Anxiety comes from these obsessions.
- They use the compulsion to try to curb the
anxiety.
- Self-help, when they need professional help
Howie Mandel
- diagnosed in mid 2000
- Teased a lot in school
for his behavior.
- hurt his career.
- Howie known as a germaphobe.
- has a separate house to get away when he
is too anxious.
Affects
- Found it hard to explain to his children
when they were young why he acted funny.
- How would employers work around it.
- Stress on many different functions of
everyday life.
Cognitive-Behavioral Therapy (CBT)
● Focuses on the relationships between thoughts, feelings, and behaviors.
● Generally, 7 of 10 will benefit from treatment or medicine.
● There have been studies that show that brain functions improve while
using CBT.
● Considered a “First Line Treatment” in many anxiety disorders, including
OCD.
● Most effective CBT is know as Exposure and Response Prevention (ERP).
Exposure and Response Prevention (ERP)
● “Exposure” confronts the thoughts, images, objects and situations that
causes the Anxiety
● “Response Prevention” is basically a choice. The choice of not doing the
compulsive behavior.
● This process starts of small; focusing on the smaller rituals or checkings
that cause the least amount of anxiety; as progress is made, therapy
focuses on the rituals and checkings that cause the most anxiety.
● This type of therapy requires a commitment.
● 75% improvement with OCD
Deep Brain Stimulation
http://www.cnn.com/2014/06/24/health/bra
in-stimulation-ocd/
Deep Brain Stimulation
● New treatment
● Electrodes attached to brain
- Electrical impulses sent through brain
● Used in cases where conventional methods
have not worked
Pharmacotherapy
● Started back in the 1960s and uncontrolled
● Clomipramine
o a tricyclic antidepressant with specific inhibitor of the reuptake of
serotonin
o increases activity of certain chemicals in the brain
o 25mg every day at bedtime
● 1980s controlled
o found to be an important advancement
o trials then lead to a superior drug
● Fluvoxemine
o SSRI (selective serotonin reuptake inhibitor)
o affects chemicals in the brain that become unbalanced
o 20mg every day
Pharmacotherapy
● Pretty effective
● SSRIs (Selective Serotonin Reuptake Inhibitor)
o the most effective pharmacotherapy for OCD
o considered to be “first-line”
● Differs person to person
● Differs from those with anxiety and depression in two major ways:
o 1. OCD have a higher dosage of the SSRIs before seeing big changes
o 2. Improvements are gradual usually over 10-12 weeks
References
Pallanti S, Hollander E, Goodman WK
J Clin Psychiatry. 2004; 65 Suppl 14():6-10
Barbieri V, Lo Russo G, Francione S, Scarone S, Gambini O
Epilepsy Behav. 2005 Jun; 6(4):617-9.
Tass PA, Klosterkötter J, Schneider F, Lenartz D, Koulousakis A, Sturm V
Neuropsychopharmacology. 2003 Jul; 28 Suppl 1():S27-34.
Haddad, Jessica, Eric M. Stauss. “Germs: ‘No Deal’ for Host Howie Mandel.” ABC News. ABC
New Network, 24 Nov. 2009. Web. 08 Apr. 2015.
Diagnostic and Statistical Manual of Mental Disorders: DSM-V. 5th ed. Washington, D.C.: American Psychiatric Association, 2013. Print.
“Deep Brain Stimulation.” - Mayo Clinic. Web. 12 Apr. 2015.
Thomas, J. “Deep Brain Stimulation Surgery for OCD: On Safety, Efficacy--and Financial Incentives.” Psychiatric Times 29.9 (2011): 1-10. Print.
Nichols, Hannah. "What Is Obsessive-compulsive Disorder (OCD)? What Causes Obsessive-compulsive Behavior?" Medical News Today. MediLexicon International, 23
Dec. 2014. Web. 13 Apr. 2015.
“Cognitive Behavior Therapy.” International OCD Foundation. N.p., 27 May 2014. Web. 14 Apr. 2015.
“Obsessive-Compulsive Disorder: An Information Guide.” CAMH: Treatments for OCD: Cognitive-behavioural Therapy. N.p., n.d. Web. 14 Apr. 2015
"Treatments & Services." NAMI: National Alliance on Mental Illness. N.p., n.d. Web. 14 Apr. 2015.