2. Obsessive Compulsive Disorder

3. During the lecture …… What is obsessive compulsive disorder
What are the clinical features
Differential Diagnosis
Aetiology
Prognosis
Management

4. What is an obsession ? Recurrent persistent thoughts, impulses,
or images
that enter the mind despite the person’s efforts to exclude them.

5. Patient resists the obsession.
Recognizes them as his/her own.
Regarded as untrue or senseless.
Generally about matters which the patient finds distressing or unpleasant.

6. Several forms of obsessions
Thoughts
Ruminations
Doubts
Impulses
Rituals

7. Compulsions
Repetitive and seemingly purposeful behaviours performed in a stereotyped manner.
Usually associated with obsessions
Usually reduces the stress caused by the latter
Feels they have to do it
But also wants to resist

9. OBSESSIONS
COMPULSIONS
OBSESSIONAL SLOWNESS

10. Other Associated features
Features of Anxiety Depression

11. Differential Diagnosis
Generalized Anxiety Disorder Panic Disorder Phobic Disorder Depression Schizophrenia Organic cerebral disorders

12. How common is it ?
Lifetime prevalence : 1.9 to 2.5 One year prevalence : 1.2 to 1.8

13. Aetiology Genetic Brain disorder Abnormal serotonergic function
Early experiences

14. Management
Assess
Make a definite diagnosis
Treat

15. Treatment
Explain the symptoms Reassure Interview relatives encourage them to be firm with the patient.

16. Drug Treatment Clomipramine –
A tricyclic with 5-HT uptake blocking effects.
200 – 250 mg daily
side effects - anticholinergic
May take six weeks to see desired effects

17. Selective Serotonin reuptake inhibitors -
Flouxetine, fluvoxamine
side effects are less
Treat Associated depression if present.

18. Behaviour therapy
Exposure and response prevention

19. Anxiety
Time

20. THANK YOU !