تدريب Shadowing: Obsessive-Compulsive Disorder Explained Clearly (OCD) - تعلم التحدث بالإنجليزية عبر الفيديو

In this video, we'll cover obsessive compulsive disorder, and you'll find free practice material including multiple choice questions,

case scenarios and flashcards available through Wisdolia that gives feedback as you answer on what you got wrong and why.

Find a link to the questions below.

Obsessive-compulsive disorder, or OCD, is a condition characterized by,

as the name suggests, obsessions that are unwanted,

intrusive, recurrent thoughts, images, or urges that cause anxiety and distress, leading to an effort to avoid them,

and compulsions that are repetitive tasks performed in response to obsessions in an attempt to reduce the distress,

but are often not realistically connected.

As a result of these obsessions and compulsions, there is impairment in the individual's daily functioning and a negative impact on their quality of life.

Examples of common obsessions are a fear of contamination, a need for symmetry or exactness,

a fear of causing harm or making mistakes, and sexual or religious obsessions.

There will often There can also be avoidance of situations in which these obsessions are triggered.

Compulsions, also known as rituals, can be behavioral or mental.

Examples of behavioral compulsions include cleaning or hand washing, organizing or arranging, and checking,

while mental compulsions could be repeating words silently or praying, counting, and ruminating.

But bear in mind that the compulsions don't have to be directly connected to the obsession or the feared event.

Around 1 in 3 people with OCD will also suffer from some form of tics,

and up to 60% of the refer experiencing sensory phenomena preceding compulsions.

The cause of OCD is likely to be a combination of factors,

including genetic influence, with some evidence suggesting that it may be transmitted in an autosomal dominant fashion.

Genes thought to be involved are related to serotonin, dopamine, and glutamate neurotransmitters.

Some theories also explain that compulsions may be self-reinforcing,

as they temporarily reduce the anxiety brought on by obsessions.

PANDAS are another potential factor,

which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection,

whereby through molecular mimicry, autoimmune antibodies generated during the strep infection may cross-react with those in the basal ganglia.

Childhood acute neuropsychiatric symptoms, or CANS,

is a term that is becoming preferred to pandas because it encompasses causes other than strep, such as toxins or metabolites.

Between 1 and 4% of the population are thought to be affected, with onset typically in late adolescence to the early 20s.

Females are slightly more commonly affected, however, males have a more chronic course and an earlier onset,

as well as being more likely to encounter treatment resistance.

In around 75% of cases, there is a coexisting anxiety disorder and 63% have mood disorders,

most commonly major depressive disorder, and 10% of people with OCD attempt suicide.

Features that are associated with treatment resistance include schizotypal personality disorder and structural brain abnormalities.

A diagnosis is based on the Diagnostic and Statistical Manual,

5th edition, or DSM-5 criteria that state there must be obsessions, compulsions, or both, that they are time-consuming,

for example taking over an hour per day, and cause clinically significant distress or impairment in functioning.

They also cannot be attributable to substances or a medical condition,

and they cannot be better explained by another mental disorder.

The insight of the person should also be explored, which may range from good,

where where they are able to recognize that OCD beliefs are probably not true, to poor, where they think the OCD beliefs are true,

to absent or delusional, where they are completely convinced the OCD beliefs are true,

although a diagnosis of psychotic disorder should not be made on this basis alone.

A scale known as the Yale Brown Obsessive-Compulsive Scale is the most widely used scale to measure OCD symptoms,

with scores ranging from 0 to 40, with 40 being the most severe.

It features 5 questions each on obsessions and compulsions, and can be used to track the progress of treatment.

Overall, OCD treatment is largely divided into pharmacological and cognitive behavioral therapy first line.

However, 40% of patients fail to see a benefit from either of these.

Pharmacological therapy includes use of selective serotonin reuptake inhibitors like sertraline, fluoxetine, or paroxetine.

However, clomipramine, which is a serotonin-specific tricyclic antidepressant is another option.

CBT is typically in the form of exposure and response prevention, where a number of triggers are identified and graded.

Then the patient is encouraged to expose themselves to them and then refrain from the compulsive rituals.

And as the symptoms improve, the more severe triggers are then targeted.

Second line agents include the addition of antipsychotics.

Patients are considered non-responders when there is no response to two SSRIs

and clomipramine taken for 12 weeks each with cognitive behavioral therapy.

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تدريب Shadowing: Obsessive-Compulsive Disorder Explained Clearly (OCD) - تعلم التحدث بالإنجليزية عبر الفيديو

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