• Obsessions: recurrent, intrusive, unwanted thoughts (i.e. fear of contamination)• Compulsions: behaviors or rituals aimed at reducing distress or preventing a dreadful event (i.e., compulsive hand washing)Common Obsessions:• Contamination: cleaning, hand washing, showering• Repeated doubts: checking, requesting or demanding reassurances from others, counting• Order: checking, rituals, counting• Aggressive or horrific images, checking, prayers, rituals• Sexual/pornographic imagery: prayer/rituals• ScrupulosityEpidemiology of OCD:• Lifetime prevalence is 2-3% in the general population• Mean age of onset is mid-twenties, although men may develop symptoms earlier• Less than 5% of patients develop disease after age of 35 years• Chronic course, stress can exacerbate symptomsOCD Treatment:• Serotonin reuptake inhibitors• Clomipramine, a serotonergic trisyclic antidepressant• Psychotherapy: exposure and response prevention• 0-100= SUDS= subjective units of distress (0-none, 100-high anxiety)• Identify your 0-100 events• 100- someone coughing near son• 80- someone else holding son• 60- others bring mud into home• 45- entertaining guests• 30- touching door handle• Exposure to events sequentially• Review thoughtsOCD is not OCPD:• OCD is different from obsessive compulsive personality disorder• OCPD: a pervasive pattern of preoccupation with orderliness, perfectionism, and control that begins by early
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