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OBSESSIVE-COMPULSIVE
DISORDER (OCD)
JIM BOYCE
ALEJANDRO OLGUIN
BRYANNA HUTCHINS
COURTNEY OHMAN
PREVALENCE
• 1.6% lifetime prevalence
• Onset in late adolescence/early adulthood
• Usually chronic
• Equal between genders
• High comorbity with depression (70% lifetime prevalence with OCD
PATHOLOGY• Increased metabolic activity in the basal ganglia
• PET scans have strongly implicated involvement of the orbito-frontal cortex, the caudate nucleus, and the thalamus
• Primitive cleaning and checking behaviors are “hard-wired” in the thalamus
• Most OCD cases represent an abnormality of serotonergic functioning in the fronto-striatal-thalamo-cortical circuit
PATHOLOGY (CONTINUED)
• Increased activity in the head of the caudate nucleus inhibits Globus pallidus fibers that ordinarily dampen thalamic activity
• This resulting increase in the thalamic activity produces increased activity in the orbitofrontal cortex
• This completes the circuit, via the cingulate gryus, the caudate and produces increased activity in the head of the caudate
SIGNS & SYMPTOMS People with OCD may experience;
• Obsessions of contamination
• Repeatedly thoughts and images
• Irrational fear of injury or diseases
• Inappropriate sexual thoughts
• Shaking, nail-biting, plucking hairs, and other repetitive movements
• All of these intervene with daily activities and affect overall happiness
NEUROPSYCHOLOGICAL DEFICITS
These deficits affect the frontal-striatal functioning, especially in the orbitofrontal-striatal circuitry causing;
• Impairment of executive functioning.
• Visual memory and motor speed.
• Poor organization skills and poor non-verbal skills.
• Lack of proper performance in set-shifting, alternation, and response inhibition.
TREATMENTS• Cognitive Behavioral Therapy (CBT)
• CBT is a psychological treatment based on one’s symptoms, treatment procedures, and a specified outcome
• Helps construct cognitive abilities
• Helps reduce the level of anxiety which lead to acts of obsession.
• Pharmacotherapy• Treatment using drugs, especially SSRI’s that inhibit the uptake of serotonin
after released in the synapses
• Messages are being transmitted between two nerve cells from a chemical synapse which creates a small gap. The presynaptic cell sends information releasing into the neurotransmitters. Serotonin is filled by these gaps.
• SSRI Drugs used include Clomipramine, Fluoxetine, Sertraline, & Fluvoxamine
TREATMENTS (CONTINUED)
• Psychosurgery
• Used only in severe cases
• Used if patients fail to respond to medication and therapy
• Surgical techniques are singulotomy and leucotomy
• 25-30% of patients benefit from surgery