Obsessive Compulsive DisorderOCD University Psychiatry强迫症OCD大学精神病学.pptVIP

Obsessive Compulsive Disorder (OCD) Wayne K. Goodman, MD Director, Division of Adult Translational Research Treatment Development National Institute of Mental Health Bethesda, MD Learning Objectives To reliably diagnose OCD and differentiate it from other anxiety disorders To learn the basis for the theories of pathophysiology of OCD To learn the evidence for a rationale approach to the treatment of OCD Outline Nosology, Phenomenology Differential Diagnosis Demographics, Prevalence and Course Putative Subtypes Pathophysiology Serotonin and neurochemical hypotheses Neuroanatomical circuits Pathogen-triggered autoimmune-mediated theory Outline (cont’d) of Treatment Behavioral therapy Pharmacotherapy basics Preferential efficacy of SRIs Measuring change Approaches to treatment-resistant OCD Augmentation strategies (e.g., adding antipsychotics) Novel biological interventions (e.g., deep brain stimulation) Question #1 Which may be a manifestation of OCD? a. distorted belief of being fat and counting calorie intake not to exceed 1000 per day b. can’t get ex-girlfriend out of his mind and feels compelled to know her whereabouts c. recognizes irrationality of need to check envelopes to ensure 5-year old daughter is not inside d. compulsively eats everything in front of him and feels guilty afterwards Question #2 The serotonin hypothesis of OCD is a. supported by PET imaging studies b. no longer consistent with treatment studies c. based primarily on preferential response of SRIs d. confirmed by post-mortem data Question #3 The brain regions implicated in OCD are a. orbito-frontal cortex and basal ganglia b. amygdala and cerebellum c. hippocampus and locus ceruleus d. unknown Question #4 Evidenced based treatments for OCD include a. SSRIs and buspirone b. SSRIs, SNRIs and alprazolam c. SSRIs, clomipramine and CBT d. SSRIs and ECT Question #5 Use of antipsychotics in OCD is a. inappropriate because these patients are not psychotic b. confined to