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11 Cards in this Set
- Front
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Q. Biological therapies for OCD |
Chemotheraphy -Antidepressants = reduce anxiety related to OCD, e.g. SSRIs & Tricyclic clomipramine, -Anti anxiety = Benzodiazepines (BZs) and D-Cycloserine Psychosurgery -Cingulotomy & Capsulotomy -Transcranial stimulation (TNS) -Deep brain Stimulation (DBS) |
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Q.How do anti-depressants treat OCD |
SSRIs reduce anxiety associated with OCD e.g. prozac -They work by increasing serotonin (which is associated to OCD and anxiety) -SSRIs stop the reuptake of serotonin which leaves more serotonin in the synapse -Serotonin also implicated in the 'worry circuit' |
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Q.How do anti anxiety drugs treat OCD (3steps) & the other drug |
Benzodiazepines (anti-anxiety): 1st- BZs slow down activity in the CNS 2nd-By enhancing GABA activity, which has a calming effect on the neurons in the brain 3rd-As GABA locks into the receptors & opens the channel which increase the flow of Chloride ions into the neuron => makes it harder to be stimulated by other neurotransmitters D-Cycloserine An antibiotic used to treat tuberculosis, has an effect on reducing anxiety - could be used to treat OCD, esp when used with psychotherapy. Als appears to enhance GABA activity |
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Q.The effectiveness of chemotherapy -3 studies |
-Koran, studies are 3-4months = no long-term data -Soomro, reviewed 17 studies, found drugs were more effective than placebos - supports effectiveness as shows benefit were due to the drug -Szetehman, 50%-70% report reduction of symptoms |
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Q. Eval the appropriateness of chemotherapy - 4 studies |
-Koran, sponsored review by APA, suggeted that psychotherapies should be used first. -Drugs take little effort and are effective in the short term but... ...patients are likely to relapse within a few weeks if medication is stopped, Maina -Soomro, potential side effects e.g. nausea, headache & insomnia - reduces appropriateness as side effects may outweigh/reduce the benefits -Schwartz, found that behavioural therapy can be sufficient without drugs |
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Q. What is cingulotomy & capsulotomy |
-The removal of the Cingulum & Capsule in the brain Capsule: part to the limbic system, which is involved in emotions & anxiety Cingulum: connects the Orbitofrontal cortex (OFC) to the Caudate Nucleus. *LS = Capsule |
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Q. What is deep brain stimulation & transcranial stimulation |
DBS: Wires are placed on targeted areas of patients brain & connected to battery in patients chest. The current would disrupt the targeted circuits e.g. the worry circuit TNS: large electromagnetic coil is placed above patient's scalp. Creates a painless current that stimulates the frontal cortex - associated with mood & anxiety |
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Issues with classification/diagnosis of OCD |
Reliability: Consistency of measuring the instrument Woody et al, assessed 54 patients and found good internal consistency. -Inter-rater reliability was excellent -Test retest after an avg interval of 48.5 was lower than desirable Kim et al, good test retest results over short-term e.g. 2 weeks Validity Validity of Diagnosis: -YBOCS questionnaire = demand characteristics e.g. social desirability, may write to fit what interviewer wants - May not understand questionnaire - May not be aware of severity of their symptoms Discriminant validity, ability to distinguish between OCD and other conditions - Rosenfeld et al, patients with OCD scored higher on Y-BOCS - Woody et al, found poor discrimination between depression & OCD |
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Q. Bio exp for OCD (Genes & neuroanatomy) |
Genetics: - certain genes may influence brain structure leading to abnormalities and may impact ability to perform mental tasks - lead to anxiety - OCD Studies: -Brain structure: 1. damage to Basal ganglia - in frontal lobe - controls thinking & judgement 2. 'worry circuit': OFC -> caudate nucleus to regulate signals -> thalamus -> OFC -CN should suppress minor worries - damage = that thalamus is overactive - anxiety - OCD |
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Q. Studies for Bio exp |
Genes: Nestadt(2000): 80-OCD + 343 fam & 73-non + 300 fam = relatives are 5x more likely Arbor - relatives 9x Blacks - only 2.5% of relatives =population Billet: meta-A, 14 studies = MZ twins 2x Casey & Gottesman: MZ = 87% DZ = 47% Andrews: No higher concordance Brain struct: Wise & Rapport: basal ganglia & parkinsons - parkinsons linked to OCD= basal ganglia - OCD Menzie: 31 OCD, 31 relatives, 31 cntrl - ability to stop repetitive behaviour - fam & OCD = hard to stop + less grey matter in OFC |
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Q. Diagnostic criteria for OCD (Who, what, where & why) |
OCD: an anxiety disorder involving obsessions & compulsions O: are intrusive, recurrent thoughts/images/impulses that are distressing/inappropriate/forbidden C: irresistible physical or mental actions people feel compelled to carry out that reduce the anxiety Who: the patient What: they are repetititve & unpleasant - try to resist them When: compulsions are persistent for at least 2 weeks Where: they are not from another mental disorder - originate from the mind not external Why: they cause distress/interfere with life (are not pleasurable) |
