{"id":2722,"date":"2010-02-13T18:28:34","date_gmt":"2010-02-13T23:28:34","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=2722"},"modified":"2010-02-13T19:57:18","modified_gmt":"2010-02-14T00:57:18","slug":"obsessivecompulsive-disorder","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/02\/obsessivecompulsive-disorder\/","title":{"rendered":"Obsessive-Compulsive Disorder"},"content":{"rendered":"
1)<\/strong> compulsive behavior and\/or obsessive thoughts that impair everyday functioning 2)<\/strong> usually occurs for at least one hour a day<\/p>\n Signs and Symptoms<\/strong><\/p>\n 1)<\/strong> repetitive handwashing 2)<\/strong> repetitive counting 3)<\/strong> checking repeatedly as to whether a task has been accomplished 4)<\/strong> fear of germs or contamination 5)<\/strong> repetitive hair pulling (trichotillomania) with bald spots or missing eyebrows or lashes 6)<\/strong> wish to conceal their compulsion 7)<\/strong> feeling of anxiety if compulsive behavior is denied 8)<\/strong> tends to have a prolonged and waxing and waning course<\/p>\n Characteristic Test Findings<\/strong><\/p>\n Radiology<\/em> – positive PET scan findings in caudate nucleus and frontal white matter (PET scans “light up positive) in areas that have high glucose metabolism)<\/p>\n Histology\/Gross Pathology<\/strong><\/p>\n 1)<\/strong> decreased size of caudate nucleus 2)<\/strong> abnormal frontal lobe white matter<\/p>\n Biochemistry<\/strong><\/p>\n increased glucose metabolism in head of caudate nucleus and orbital cortex of frontal lobes<\/p>\n Associated Conditions<\/strong><\/p>\n Tourette’s disorder<\/p>\n Inheritance\/Epidemiology<\/strong><\/p>\n 1)<\/strong> lifetime prevalence is 2% worldwide 2)<\/strong> onset is usually in early adulthood but adolescent onset does occur 3)<\/strong> more common in males and firstborn 4)<\/strong> familial predisposition does occur with increased concordance in monozygotic twins<\/p>\n Treatment<\/strong><\/p>\n 1)<\/strong> drugs – fluoxetine, fluvoxamine (sometimes in combination with buspirone and benzodiazepine) 2)<\/strong> behavior therapy – with gradual increase in stressors and substitions of less disruptive activity for compulsions<\/p>\n Tips for USMLE<\/strong><\/p>\n if the patient is a 23 year old man who cannot start work in the morning without washing off the surface of his desk exactly 17 times, think obsessive compulsive disorder
\nPathophysiology<\/strong><\/p>\n
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