CMN 552 UNIT 3 QUESTION AND ANSWERS
1. What are the common symptoms represented in OCD? (Sadock, p. 418) - -
intrusive thoughts, rituals, preoccupations, and compulsions
2. Differentiate between an obsession and a compulsion. (Sadock, p. 418) - -
Obsession: A recurrent and intrusive thought, feeling, idea, or sensation.
Compulsion: A conscious, standardized, recurrent behavior, such as counting, checking,
or avoiding
3. What is the prevalence of OCD? - - Lifetime prevalence in the general population
estimated at 2 to 3 percent.
Fourth most common psychiatric diagnosis.
Among adults, men and women are equally likely to be affected.
Among adolescents, boys are more commonly affected than girls.
Mean age of onset is about 20 years.
The onset of the disorder can occur in adolescence or childhood, in some cases as early as
2 years of age.
Single persons are more frequently affected with OCD than are married persons, although
this finding probably reflects the difficulty that persons with the disorder have maintaining
a relationship.
Occurs less often among blacks than among whites,
although access to health care rather than differences in prevalence may explain the
variation.
4. What are the common comorbid psychiatric conditions in patients with OCD? Sadock p.
418 - - The lifetime prevalence for major depressive disorder with OCD is 67 percent
and social
,CMN 552 UNIT 3 QUESTION AND ANSWERS
phobia 25 percent.
Also, alcohol use disorder, generalized anxiety disorder, specific phobia, panic disorder,
eating disorders, and personality disorders. Tourette's disorder 5-7 percent.
Tics 20-30 percent.
What are the risk factors for the development of OCD? Sadock p. 419 - - There is a
significant genetic component.
6. What etiological factors have been attributed to the development of OCD? Sadock p.
419-420 - - There is a positive link between streptococcal infections and OCD.
Altered function in neurocircuitry between orbitofrontal cortex, caudate, and thalamus.
Increased activity in the
frontal lobes, basal ganglia and cingulum. Bilaterally smaller caudates.
7. Review the psychosocial factors for the development of OCD. (Sadock, p. 420) - -
OCD differs from obsessive-compulsive personality disorder, which is associated with an
obsessive concern for details, perfectionism, and other similar personality traits.
Most persons with OCD do not have premorbid compulsive symptoms, and such
personality traits are neither necessary nor sufficient for the development of OCD. Only
about 15 to 35 percent of patients with OCD have had premorbid obsessional traits.
Many patients with OCD may refuse to cooperate with effective treatments such as
selective serotonin reuptake inhibitors (SSRis) and behavior therapy.
Patients may become invested in maintaining the symptomatology because of secondary
gains. For example, a male patient, whose mother stays home to take care of him, may
unconsciously wish to hang on to his OCD symptoms because they keep the attention of
his mother.
,CMN 552 UNIT 3 QUESTION AND ANSWERS
Research suggests that OCD may be precipitated by a number of environmental stressors,
especially those involving pregnancy, childbirth, or parental care of children. An
understanding of the stressors may assist the clinician in an overall treatment plan that
reduces the stressful events themselves or their meaning to the patient.
8. In OCD patients, what is "magical thinking"? (Sadock, p. 421) - - Persons believe
that merely by thinking about an event in the external world they can cause the event to
occur without intermediate physical actions.
In what ways can the psychiatric nurse practitioner characterize (specify) insight in the
OCD patient? (Sadock, p. 421) - - Patients with good or fair insight recognize that
their OCD beliefs are definitely or probably not true or may or may not be true.
Patients with poor insight believe their OCD beliefs are probably true.
Patients with absent insight are convinced that their beliefs are true.
What are the diagnostic/clinical features of OCD? Sadock p.421 - - Patients with
OCD often take their complaints to physicians other than psychiatrist.
Most patients with OCD have both obsessions & compulsions - up to 75%. Obsessions and
compulsions are the essential feature of OCD.
Sometimes, patients overvalue obsessions and compulsions, for example they may insist
that compulsive cleanliness is morally correct, even though they have lost their jobs
because of time spent cleaning.
What are the 4 major symptom patterns in OCD? Sadock p421-422 - --
Contamination
-Pathological Doubt
-Intrusive Thoughts
-Symmetry
-Other: religious obsessions and compulsions, hair pulling, nail biting, masturbation
, CMN 552 UNIT 3 QUESTION AND ANSWERS
12. What is the DSM 5 diagnostic criteria for diagnosing a patient with OCD? Sadock 422 -
- A: The presence of obsessions, compulsions, or both. Obsessions are defined by
(1) and (2) as follows:
1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time
during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress
2. The person attempts to suppress or ignore such thoughts, impulses, or images or to
neutralize them with some other thought or action (i.e. performing a compulsion
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (eg, hand washing, ordering, checking) or mental acts (eg, praying,
counting, repeating words silently) in response to an obsession or according to rules that
must be applied rigidly
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing
some dreaded event or situation; however, these behaviors or mental acts either are not
connected in a way that could realistically neutralize or prevent whatever they are meant to
address, or they are clearly excessive
NOTE: young children may not be able to articulate the aims of these behaviors or mental
acts.
B: The obsessions or compulsions are time consuming (e.g. take more than 1 hour per day)
or cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning
C: The obsessive-compulsive symptoms are not attributable to the physiological effects of
a substance(e.g., a drug of abuse, a medication) or another medical condition.
D: the disturbance is not better explained by the symptoms of another mental disorder
Specify if:
-with good or fair insight: the individual recognizes that OCD beliefs are definitely or
probably not true or that they may not be true
-with poor insight: the individual thinks OCD beliefs are probably true
-with absent insight/delusional beliefs: the individual is co
What are the reasons other clinical specialists are likely to be seeing a patient with OCD? -
- Patients with OCD often take their complaints to physicians rather than
1. What are the common symptoms represented in OCD? (Sadock, p. 418) - -
intrusive thoughts, rituals, preoccupations, and compulsions
2. Differentiate between an obsession and a compulsion. (Sadock, p. 418) - -
Obsession: A recurrent and intrusive thought, feeling, idea, or sensation.
Compulsion: A conscious, standardized, recurrent behavior, such as counting, checking,
or avoiding
3. What is the prevalence of OCD? - - Lifetime prevalence in the general population
estimated at 2 to 3 percent.
Fourth most common psychiatric diagnosis.
Among adults, men and women are equally likely to be affected.
Among adolescents, boys are more commonly affected than girls.
Mean age of onset is about 20 years.
The onset of the disorder can occur in adolescence or childhood, in some cases as early as
2 years of age.
Single persons are more frequently affected with OCD than are married persons, although
this finding probably reflects the difficulty that persons with the disorder have maintaining
a relationship.
Occurs less often among blacks than among whites,
although access to health care rather than differences in prevalence may explain the
variation.
4. What are the common comorbid psychiatric conditions in patients with OCD? Sadock p.
418 - - The lifetime prevalence for major depressive disorder with OCD is 67 percent
and social
,CMN 552 UNIT 3 QUESTION AND ANSWERS
phobia 25 percent.
Also, alcohol use disorder, generalized anxiety disorder, specific phobia, panic disorder,
eating disorders, and personality disorders. Tourette's disorder 5-7 percent.
Tics 20-30 percent.
What are the risk factors for the development of OCD? Sadock p. 419 - - There is a
significant genetic component.
6. What etiological factors have been attributed to the development of OCD? Sadock p.
419-420 - - There is a positive link between streptococcal infections and OCD.
Altered function in neurocircuitry between orbitofrontal cortex, caudate, and thalamus.
Increased activity in the
frontal lobes, basal ganglia and cingulum. Bilaterally smaller caudates.
7. Review the psychosocial factors for the development of OCD. (Sadock, p. 420) - -
OCD differs from obsessive-compulsive personality disorder, which is associated with an
obsessive concern for details, perfectionism, and other similar personality traits.
Most persons with OCD do not have premorbid compulsive symptoms, and such
personality traits are neither necessary nor sufficient for the development of OCD. Only
about 15 to 35 percent of patients with OCD have had premorbid obsessional traits.
Many patients with OCD may refuse to cooperate with effective treatments such as
selective serotonin reuptake inhibitors (SSRis) and behavior therapy.
Patients may become invested in maintaining the symptomatology because of secondary
gains. For example, a male patient, whose mother stays home to take care of him, may
unconsciously wish to hang on to his OCD symptoms because they keep the attention of
his mother.
,CMN 552 UNIT 3 QUESTION AND ANSWERS
Research suggests that OCD may be precipitated by a number of environmental stressors,
especially those involving pregnancy, childbirth, or parental care of children. An
understanding of the stressors may assist the clinician in an overall treatment plan that
reduces the stressful events themselves or their meaning to the patient.
8. In OCD patients, what is "magical thinking"? (Sadock, p. 421) - - Persons believe
that merely by thinking about an event in the external world they can cause the event to
occur without intermediate physical actions.
In what ways can the psychiatric nurse practitioner characterize (specify) insight in the
OCD patient? (Sadock, p. 421) - - Patients with good or fair insight recognize that
their OCD beliefs are definitely or probably not true or may or may not be true.
Patients with poor insight believe their OCD beliefs are probably true.
Patients with absent insight are convinced that their beliefs are true.
What are the diagnostic/clinical features of OCD? Sadock p.421 - - Patients with
OCD often take their complaints to physicians other than psychiatrist.
Most patients with OCD have both obsessions & compulsions - up to 75%. Obsessions and
compulsions are the essential feature of OCD.
Sometimes, patients overvalue obsessions and compulsions, for example they may insist
that compulsive cleanliness is morally correct, even though they have lost their jobs
because of time spent cleaning.
What are the 4 major symptom patterns in OCD? Sadock p421-422 - --
Contamination
-Pathological Doubt
-Intrusive Thoughts
-Symmetry
-Other: religious obsessions and compulsions, hair pulling, nail biting, masturbation
, CMN 552 UNIT 3 QUESTION AND ANSWERS
12. What is the DSM 5 diagnostic criteria for diagnosing a patient with OCD? Sadock 422 -
- A: The presence of obsessions, compulsions, or both. Obsessions are defined by
(1) and (2) as follows:
1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time
during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress
2. The person attempts to suppress or ignore such thoughts, impulses, or images or to
neutralize them with some other thought or action (i.e. performing a compulsion
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (eg, hand washing, ordering, checking) or mental acts (eg, praying,
counting, repeating words silently) in response to an obsession or according to rules that
must be applied rigidly
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing
some dreaded event or situation; however, these behaviors or mental acts either are not
connected in a way that could realistically neutralize or prevent whatever they are meant to
address, or they are clearly excessive
NOTE: young children may not be able to articulate the aims of these behaviors or mental
acts.
B: The obsessions or compulsions are time consuming (e.g. take more than 1 hour per day)
or cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning
C: The obsessive-compulsive symptoms are not attributable to the physiological effects of
a substance(e.g., a drug of abuse, a medication) or another medical condition.
D: the disturbance is not better explained by the symptoms of another mental disorder
Specify if:
-with good or fair insight: the individual recognizes that OCD beliefs are definitely or
probably not true or that they may not be true
-with poor insight: the individual thinks OCD beliefs are probably true
-with absent insight/delusional beliefs: the individual is co
What are the reasons other clinical specialists are likely to be seeing a patient with OCD? -
- Patients with OCD often take their complaints to physicians rather than
