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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 ● ● ● ● 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.