OBSESSIVE-COMPULSIVE DISORDER
A reduction in the CSF 5-HIAA (Hydroxyindoleacetic Acid) is associated with all the following, EXCEPT:
| A |
Suicide |
|
| B |
OCD |
|
| C |
Depression |
|
| D |
Violence |
A reduction in the CSF 5-HIAA (Hydroxyindoleacetic Acid) is associated with all the following, EXCEPT:
| A |
Suicide |
|
| B |
OCD |
|
| C |
Depression |
|
| D |
Violence |
The CSF levels of 5-HIAA (Hydroxyindoleacetic Acid) is low in patients who committed suicide, in depression and violence.
It is considered to be associated with poor impulse control. It can be used to predict suicide.
It is not known to be reduced in OCD.
Ref: Kaplan & Sadock’s Synopsis of Psychiatry, By Benjamin J Sadock, M.D., Harold I. Kaplan, Virginia A Sadock, M.D, 10th Edition, Page : 265
A 15 year old boy feels that the dirt has hung onto him whenever he passes through the dirty street. This repetitive thought causes much distress and anxiety. He knows that there is actually no such thing after he has cleaned once but he is not satisfied and is compelled to think so. This has led to social withdrawal. He spends much of his time thinking about the dirt and contamination. This has affected his studies also. The most likely diagnosis is :
| A |
Agoraphobia |
|
| B |
Conduct disorder |
|
| C |
Adjustment disorder |
|
| D |
Obsessive compulsive disorder |
A 15 year old boy feels that the dirt has hung onto him whenever he passes through the dirty street. This repetitive thought causes much distress and anxiety. He knows that there is actually no such thing after he has cleaned once but he is not satisfied and is compelled to think so. This has led to social withdrawal. He spends much of his time thinking about the dirt and contamination. This has affected his studies also. The most likely diagnosis is :
| A |
Agoraphobia |
|
| B |
Conduct disorder |
|
| C |
Adjustment disorder |
|
| D |
Obsessive compulsive disorder |
The boy in the question is suffering from obsessive compulsive disorder.
Which of the following is associated with obsessive compulsive dissorder?
| A |
Mania |
|
| B |
Depression |
|
| C |
Delusion |
|
| D |
Schizophrenia |
Which of the following is associated with obsessive compulsive dissorder?
| A |
Mania |
|
| B |
Depression |
|
| C |
Delusion |
|
| D |
Schizophrenia |
At least ½ of the people with OCD later develop sever depressive episode. They are considered as a seperate condition.
A 12-year-old boy is brought to your clinic for being very strange in his behaviours. He is late to school because he has to be in the shower for more than 2 hours. He feels compelled to use the soap repeatedly to clean off the ‘germs’ which he is worried off. He feels compelled to do this although he thinks that it is senseless. He checks his bag for his pen every 5 minutes. He has always struggled to complete his exams in time. Which of the following is the MOST likely diagnosis?
| A |
Specific phobia for germs |
|
| B |
Autism Spectrum Disorder |
|
| C |
Obsessive Compulsive Disorder |
|
| D |
Cyclothymia |
A 12-year-old boy is brought to your clinic for being very strange in his behaviours. He is late to school because he has to be in the shower for more than 2 hours. He feels compelled to use the soap repeatedly to clean off the ‘germs’ which he is worried off. He feels compelled to do this although he thinks that it is senseless. He checks his bag for his pen every 5 minutes. He has always struggled to complete his exams in time. Which of the following is the MOST likely diagnosis?
| A |
Specific phobia for germs |
|
| B |
Autism Spectrum Disorder |
|
| C |
Obsessive Compulsive Disorder |
|
| D |
Cyclothymia |
Obsessive Compulsive Disorder is associated with intrusive thoughts (obsessions) and unusual rituals and activities (compulsions).
It is recognised by the patient as senseless.
In this scenario, repeated thoughts of germs is obsession and repeated cleaning and checking for pen in his bag is compulsion.
Majority of the cases of OCD begin in adolescence.
Specific phobia for germs: will not have compulsions or obsessions. It will lead to avoidance of contaminated objects.
Ref: Kaplan & Sadock’s Synopsis of Psychiatry, By Benjamin J Sadock, M.D., Harold I. Kaplan, Virginia A Sadock, M.D, 10th Edition, Page : 1271
A college student is brought to the student health center at the urging of his roommate. He has been missing class because he needs to check the room lock many times before he can leave. Once he starts to ride his bicycle to class, he frequently returns several times to lock the door. He repeats this ritual every morning and often when he leaves the house. He misses his appointments and his academic performance suffers. His hands are chafed. Which of the following is the most likely diagnosis?
| A |
Generalized anxiety disorder |
|
| B |
Obsessive compulsive disorder |
|
| C |
Panic disorder |
|
| D |
Paranoid personality disorder |
A college student is brought to the student health center at the urging of his roommate. He has been missing class because he needs to check the room lock many times before he can leave. Once he starts to ride his bicycle to class, he frequently returns several times to lock the door. He repeats this ritual every morning and often when he leaves the house. He misses his appointments and his academic performance suffers. His hands are chafed. Which of the following is the most likely diagnosis?
| A |
Generalized anxiety disorder |
|
| B |
Obsessive compulsive disorder |
|
| C |
Panic disorder |
|
| D |
Paranoid personality disorder |
Following are correctly matched except
| A |
Schizophrenia-Audiory hallucination |
|
| B |
OCD – infidelity |
|
| C |
Alcoholism – auditory hallucination |
|
| D |
Depression – guilt feeling |
Following are correctly matched except
| A |
Schizophrenia-Audiory hallucination |
|
| B |
OCD – infidelity |
|
| C |
Alcoholism – auditory hallucination |
|
| D |
Depression – guilt feeling |
B i.e. OCD Infidelity
|
Disorder |
Feature |
|
Depression |
Delusion of guilt, poverty & nihilismQ; and pseudo dementia |
|
Mania |
Delusion of grandeurQ |
|
Schizophrenia |
– Delusion of persecution, reference, control, passivity, infidelityQ and passivity phenomenon (i.e. made feeling & acts) |
|
|
– Auditory hallucinations (3rd person hallucination & voices arguing etc) |
|
|
– 4 ‘A’ i.e. ambivalence, autism, affect & association disturbance; catatonia, verbigeration, neologism, echolalia, echopraxia, mannerism, waxy flexibility, grimacing. |
|
OCD |
– Ego – atien and ego dystonic idea0 |
|
Delirium |
– Transient delusions |
|
Delusional disorder |
|
|
– Capgrass syndrome |
– Delusion of doublesC |
|
– Othello Syndrome or |
– Delusion of infidelityQ |
|
Conjugal paranoia |
|
|
– De – clerambult’s |
– Person of high |
|
syndrome |
socioeconomic status is |
|
(Erotomania) |
in love with patientQ. |
|
– Delusional |
– Part of body or body |
|
dysmorphophobia |
being ugly or mishappenQ |
|
– Delusional |
– Delusion includes |
|
parasitosis or |
infestation by worm or |
|
Hypochondrial |
foreign bodies emitting |
|
paranomia |
a foul odour |
|
|
(Delusional halitosis) |
Ego’s defence mechanism “Undoing” is typically seen in:
| A |
Depression |
|
| B |
Schizophrenia |
|
| C |
Obsessive compulsive neurosis |
|
| D |
Hysteria |
Ego’s defence mechanism “Undoing” is typically seen in:
| A |
Depression |
|
| B |
Schizophrenia |
|
| C |
Obsessive compulsive neurosis |
|
| D |
Hysteria |
C .e. Obsession
A 35 year old man with an obsessive compulsive personality disorder is likely to exhibit all of the following features, except
| A |
Perfectionism interfering with performance |
|
| B |
Compulsive checking behaviour |
|
| C |
Preoccupation with rule |
|
| D |
Indecisiveness |
A 35 year old man with an obsessive compulsive personality disorder is likely to exhibit all of the following features, except
| A |
Perfectionism interfering with performance |
|
| B |
Compulsive checking behaviour |
|
| C |
Preoccupation with rule |
|
| D |
Indecisiveness |
D i.e. Indecisiveness
Diagnosis & Treatment In Psychiatry p-351-365; Shorter Oxford Textbook of Psychiatry 5/e p. 196-201; Neeraj Ahuja: A Short textbook of psychiatry 6/e P.101-1051
Ambivalence i.e. severe inability to decide for or against (indecisiveness) is Bleur’s fundamental symptom of schizophrenia.
Presenting symptoms of obsessive compulsive disorder (OCD)
– Persons with OCD are stubborn, rigid, overconscious, scrupulous & inflexible about matters of morality & ethics (not indecisive)Q.
Person is preoccupied with rules Q, details, list, order-organization or schedules to the extent that the major point of activity is lost.
– Shows perfection that interferes with task completion Q. eg. unable to complete project because his/her own overtly strict standards are not met.
Is excessively devoted to work and productivity to the exclusion of leisure activities & friendships. Is reluctant to delegate task or work to others. Adopts a miserly spending style.
The features of OCD are A/E
| A |
Irrationale thought |
|
| B |
Egosyntonic |
|
| C |
Resisting the idea |
|
| D |
Persistence of idea |
The features of OCD are A/E
| A |
Irrationale thought |
|
| B |
Egosyntonic |
|
| C |
Resisting the idea |
|
| D |
Persistence of idea |
B i.e. Egosyntonic
Abnormal thought possession is found in
| A |
Organic Brain syndrome |
|
| B |
Hysteria |
|
| C |
Obsessive compulsive disorder |
|
| D |
Neuroasthenia |
Abnormal thought possession is found in
| A |
Organic Brain syndrome |
|
| B |
Hysteria |
|
| C |
Obsessive compulsive disorder |
|
| D |
Neuroasthenia |
C i.e. OCD
Defence mechanism in OCD
| A |
Repression |
|
| B |
Undoing |
|
| C |
Displacement |
|
| D |
All |
Defence mechanism in OCD
| A |
Repression |
|
| B |
Undoing |
|
| C |
Displacement |
|
| D |
All |
B i.e. Undoing; A i.e. Repression > E i.e. Displacement
- OCD was thought to result from a regression from the oedipal phase to anal psychosexual phase of development, with its characteristic
preoccupation with aggression or cleanliness (anal phase)
ambivalence i.e., coexistence of love & murderous hate towards the same person/ object and sometimes simultaneously , which leaves patient in paralyzing doubt and indecision, evident as doing of undoing pattern of behaviour
– magical thinking
- Freud, surmised that unconscious impulses of sexual & aggressive nature result in OCD. These impulses 1/ t extreme anxiety, which can be reduced by the action of defence mechanisms of repression & reaction formationQ. He described isolation, undoing & reaction formationQ as three major defence mechanisms of OCD.
Features of obsessive-compulsive neurosis are
| A |
Repetitiveness |
|
| B |
Irresistibility |
|
| C |
Unpleasantness |
|
| D |
All |
Features of obsessive-compulsive neurosis are
| A |
Repetitiveness |
|
| B |
Irresistibility |
|
| C |
Unpleasantness |
|
| D |
All |
A i.e. Repetetiveness; B i.e. Irresistibility; C i.e. Unpleasantness
True about obsessive compulsive disorder is/are :
| A |
Irresistible desire to do a thing repeatedly |
|
| B |
Patient is conscious about the disorder |
|
| C |
Denial is the defense mechanism against O.C.D |
|
| D |
All |
True about obsessive compulsive disorder is/are :
| A |
Irresistible desire to do a thing repeatedly |
|
| B |
Patient is conscious about the disorder |
|
| C |
Denial is the defense mechanism against O.C.D |
|
| D |
All |
A i.e. Irresistible desire to do a thing repeatedly; C i.e. Denial is the defence mechanism against OCP; B i.e. Patient is conscious about the disorder
An idea intrudes into Conscious awareness repeatedly.
4′
– Recognized as one’s own idea but is
Ego-alien (Foreign to one’s personality) Q.
– Recognized as irrational & absurd (insight is present)Q.
– Patient tries to resist against but unable to do soQ.
Failure to resist leads to marked distress.
An obsessive compulsive neurosis patient is likely to develop
| A |
Hallucination |
|
| B |
Depression |
|
| C |
Delusion |
|
| D |
Schizophrenia |
An obsessive compulsive neurosis patient is likely to develop
| A |
Hallucination |
|
| B |
Depression |
|
| C |
Delusion |
|
| D |
Schizophrenia |
B i.e. Depression
Depression is most common psychological feature in: • OCN leads to secondary depressionQ
- AIDSQ • Pseudo dementia & Nihilistic delusions
- Post partumQ/ Post myocardial infarctionQ are seen in depressionQ
- Post surgery
- Myxedema
Obsessive Compulsive Neurosis is likely to progress into
| A |
Paronia |
|
| B |
Edogenous Depression |
|
| C |
Secondary Depression |
|
| D |
Dissociation |
Obsessive Compulsive Neurosis is likely to progress into
| A |
Paronia |
|
| B |
Edogenous Depression |
|
| C |
Secondary Depression |
|
| D |
Dissociation |
C i.e. Secondary depression
In OCN failure to control ego-alien impulse leads to development of depression, as the patient is unable to control the behaviour about which he knows that it is irrational & absurd.
Area of brain involved in OCD:
March 2004
| A |
Basal ganglia |
|
| B |
Temporal lobe |
|
| C |
Cerebellum |
|
| D |
All of the above |
Area of brain involved in OCD:
March 2004
| A |
Basal ganglia |
|
| B |
Temporal lobe |
|
| C |
Cerebellum |
|
| D |
All of the above |
Ans. A i.e. Basal ganglia
Compulsive hair pulling that produces bald spots is called:
Orissa 11
| A |
Trichotillomania |
|
| B |
Kleptomania |
|
| C |
Pyromania |
|
| D |
Diposomania |
Compulsive hair pulling that produces bald spots is called:
Orissa 11
| A |
Trichotillomania |
|
| B |
Kleptomania |
|
| C |
Pyromania |
|
| D |
Diposomania |
Ans. Trichotillomania
Fear of contamination, counting behaviors and having to check and recheck are features characteristic of:
UPSC 09
| A |
Panic attacks |
|
| B |
Agoraphobia |
|
| C |
Obsessive-compulsive disorder |
|
| D |
Generalized anxiety disorder |
Fear of contamination, counting behaviors and having to check and recheck are features characteristic of:
UPSC 09
| A |
Panic attacks |
|
| B |
Agoraphobia |
|
| C |
Obsessive-compulsive disorder |
|
| D |
Generalized anxiety disorder |
Ans. Obsessive-compulsive disorder
Repetitive hand washing is a symptom of:
NIMHANS 07; AFMC 11
| A |
Post-traumatic stress disorder |
|
| B |
Depression |
|
| C |
Anorexia nervosa |
|
| D |
Obsessive compulsive disorder |
Repetitive hand washing is a symptom of:
NIMHANS 07; AFMC 11
| A |
Post-traumatic stress disorder |
|
| B |
Depression |
|
| C |
Anorexia nervosa |
|
| D |
Obsessive compulsive disorder |
Ans. Obsessive compulsive disorder
