1. Obsessive compulsive Disorders
Khulood Alghamdi

2. Definition
An anxiety disorder in which the patient suffers from time-consuming obsessions and compulsions that interfere with normal everyday life.

3. A etiology
Genetics.
Serotonin dysfunction.
Frontal cortex and basal ganglia abnormalities.
Psychoanalytical models.

4. Characteristics:
They are recurrent and intrusive, and experienced as unpleasant or distressing.
They enter the mind against conscious resistance patients try to resist but are unable to do so.
Patient recognize obsessions as being the product of their own mind

5. RISK FACTORS/ASSOCIATIONS
Anankastic premorbid personality traits found in 70%
Co-morbid depression is present in 30% of OCD patient
15% of patients with schizophrenia have anadditional diagnosis of OCD
There are high rates of OCD in families with Tourette"s syndrome

6. EPIDEMIOLOGY
Lifetime prevalence 2-3%. M=F
Mean age of onset early
Twenties.

7. HISTORY
Obsessions and compulsions are present on most days for a period of 2 weeks and are not accounted for by the presence of mental illness such as schizophrenia. The obsessions and compulsions share.

8. The following feature:
Acknowledged as originating in the mind.
Persistent, repetitive and intrusive .
Not intrinsically pleasurable .
Cause distress and interfere with functioning OBESSIONS may be persistent thoughts, images, impulses. Common content : Contamination Bodily fears Aggression
Orderliness/symmetry.
COMPULSIONS are stereotyped acts, Often involve:
Cleaning Checking Counting Hoarding

9. EXAMINATION
Poor concentration if distracted by unwanted thoughts. May show signs of increasing anxiety if prevented from yielding to compulsions. patients recognize that the thoughts are their own and excessive.

10. DIFFERNTIAL DIAGNOSIS
Obsessive and compulsions.
Obsessive-compulsive disorder.
Eating disorders.
Obsessive-compulsive personality disorder.
Mainly obsessions.
Depressive disorder.
Other anxiety disorders.
Hypochondriacally disorder.
Schizophrenia .
Mainly compulsions.
Habit and impulse-control disorder
Gilles de la Tourette" syndrome .

11. INVESTIGATION
FBC,U+Es,LFTs,Ca,TFTs
MANAGEMENT &Treatment
Behavioral therapy(exposure and response prevention and thought stopping)
Clomipramine or SSRIs. Often symptoms relapse within weeks of discontinuing treatment.
if there is a lack of response to SSRls or clomipramine,an antipsychotic can be added.
psychosurgery can be used for sever OCD unresponsive to other treatment.

12. COMPLICATION
Difficulty with relationships, work and social function it may lead to alcohol and substance misuse.

13. PROGNOSIS
Worse prognosis if male, early onset, severe syndromes, premorbid obsessional personality disorder, life stresses.

14. Summary
OBSESSIONS: Recurrent and persistent thoughts COMPULSIONS: Repetitive behaviors or mental acts Obsessions often have themes to them, such as: washing, checking, symmetry, symptoms are common Treatment Pharmacotherapy Cognitive-Behavioral Therapy Psychosurgery Deep Brain Stimulation

15. Reference :

16. Thank you