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