OCD
- Created by: laurguy11
- Created on: 06-06-17 16:35
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- OCD
- CHARACTERISTICS
- Obsessions
- recurrent, intrusive thoughts , ideas, images or impulses, that an individual has difficulty resisting
- cause anxiety - an out of proportion fearful emotional reaction that prevents them leading a normal life
- Compulsions
- irresistible, repetitive physical or mental actions a person feels compelled to carry out
- believe they can prevent an unpleasant outcome
- checking behaviour - constant checking of lights or locks
- cleaning ritual - constant hand washing or surface cleaning
- Wilner et al (1976) - 69% have both obsessions and compulsions, 6% have only compulsions and 25% have only obsessions
- Obsessions
- BIOLOGICAL EXPLANATIONS
- Genetic
- Nestadt et al (2000) - first degree relatives of OCD sufferers had an 11.7% chance of developing the disorder
- compared to 2.7% risk in first degree relatives of control patients without OCD
- Miguel et al (2005) - 53-87% chance of both MZ twins developing OCD
- 22-47% chance for DZ twins
- genetic factors may influence brain structure and neuro-chemistry
- not 100% concordance rate between MZ twins which means environment must play a role
- Nestadt et al (2000) - first degree relatives of OCD sufferers had an 11.7% chance of developing the disorder
- Neural
- basal ganglia
- Wise and Rapoport (1989) - OCD is often found in cases of Huntington's disease, Parkinson's and Tourettes - all involve basal ganglia
- Max et al (1994) - surgery disconnecting the basal ganglia from the frontal cortex can reduce OCD symptoms
- head injuries resulting in damage to the basal ganglia can give rise to OCD symptoms
- neuro-imaging studies have so far failed to identify basal ganglia impairments in all OCD sufferers
- orbifrontal cortex
- primitive impulses to check and clean arise from the orbifrontal cortex in response to sensory inputs
- neurotransmitters
- serotonin prevents repetition, therefore low levels are implicated
- serotonin reuptake inhibitors (SRIs) are beneficial for some OCD sufferers
- basal ganglia
- Genetic
- BIOLOGICAL TREATMENT
- the only consistently effective treatment is that which focuses on neurotransmitters
- since the 1970s the most widely used drug for treating OCD has been an SRI known as clomipramine
- around 40% of OCD sufferers also suffer with depression, and so SRIs are used as they are a treatment for both disorders
- EFFECTIVENESS AND APPROPRIATENESS
- potentially unpleasant side effects
- clomipramine carries side effects such as tiredness, weight gain and heart seizures
- can take several months to notice a difference
- many report symptom improvement even if they do not effectively respond to treatment
- high relapse rate following discontinuation
- Foa et al (2005) - compared clomipramine to CBT, combined clomipramine/CBT, and a control placebo
- after 12 weeks all three treatments were more effective than the placebo
- no difference in outcomes of CBT or CBT/drug combo
- both superior to clomipramine alone
- randomised control trial - reduces allocation bias
- potentially unpleasant side effects
- the only consistently effective treatment is that which focuses on neurotransmitters
- CHARACTERISTICS
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