Presentasi Ocdz

8/19/2019 Presentasi Ocdz

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ETIOLOGY

The cause of OCD remains poorly understood.Childhood-onset OCD is estimated to be 45 to 65% heritable,and OCD with an onset durin adolescence or adulthood !" to

4"% heritable. #lthou h enomewide association studiesha$e su ested candidate enes, findin s ha$e beeninconsistent and many ha$e not been replicated or withstoodri id statistical analysis.


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Common Symptoms in OCD

Obsession Examples Associated Compulsive Behaviors

Contamination ear of bein contaminated or contaminatinothers& fear of contamination by erms, infections,or en$ironmental factors& fear of bein

contaminated by bad or immoral people

'ashin or cleanin rituals

e*ual (ecurrent thou hts about bein a pedophile or se)ually de$iant& recurrent thou hts aboutactin se)ually inappropriately toward others

#$oidin situations

+eligious Thou hts about bein immoral and eternaldamnation

#s*in for i$eness, prayin

ggressive ear of harmin others, recurrent $iolent ima es +onitorin the news for reports of $iolent crimes, as*in for reassuranceabout bein a ood

person

Control-related ear of ma*in inappropriate comments in public #$oidin bein around others

athologic doubtandcompleteness

(ecurrent worries about doin thin s incorrectlyor incompletely that thereby may ne ati$elyaffect others or the patient

Chec*in e)cessi$ely, performinactions in a particular order

uperstition-related

ears of certain bad numbers or colors Countin e)cessi$ely

ymmetry ande*actness

(ecurrent thou hts of needin to do thin s in a balanced or e)act fashion Orderin and arran in


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Criteria for the Diagnosis of Obsessive Compulsive Disorder (OCD)


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anagement sychotherapy

1. Exposure-and-response-prevention therapy/*posure and response prevention consists of repeated andprolonged e*posures to fear-eliciting stimuli or situations, combined

ith instructions for strict abstinence from compulsive behaviors.0ear-eliciting stimuli or situations are presented in a hierarchicalmanner, beginning ith moderately distressing ones andprogressing to more distressing cues. %he therapist then instructsthe patient to abstain from the compulsive behavior that the patientbelieves ill prevent the feared outcome or reduce the distress(e.g., ashing hands after touching the toilet handle).


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anagement sychotherapy

2. Co nitive TherapyCognitive therapy for OCD focuses on teaching patientsto identify and correct their dysfunctional belief aboutfeared situations. Cognitive therapy assists patients inreducing an*iety and compulsions by identifying theseautomatic unrealistic thoughts and changing theirinterpretations.


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harmacotherapy

1n addition to e*posure and responseprevention, pharmacotherapy ith the tricyclicantidepressant clomipramine or a selective

serotonin-reupta2e inhibitor ( +13 paro*etine,4uvo*amine, 4uo*etine, citalopram,escitalopram, and sertraline) has sho n e5cacyin OCD.


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Conclusions

Once the dia nosis is made, the clinician should educate the patient aboutthe nature of the illness, includin the low fre uency of spontaneousimpro$ement but the hi h li*elihood of responsi$eness to therapy.The patient should be informed that e)posure-and-responsepre$entiontherapy and pharmacotherapy with an //(0 are considered to be first-line

treatments that impro$e OCD symptoms in a ma1ority of patients.To help the patient choose his treatment, he should be educated re ardinthe process of e)posure therapy and the probable en th of treatment2wee*ly sessions for appro)imately 36 wee*s, followed by some monthlysessions . /imilarly, he should be educated re ardin medication sideeffects and told that medication ou ht to be continued for at least

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Presentasi Ocdz