Changes DSM-IV to DSM-V
- New disorders under “obsessive-compulsive and related disorders”
- Hoarding disorder
- Excoriation (skin-picking) disorder
- Substance-/ medication-induced obsessive-compulsive and related disorder
- Obsessive-compulsive and related disorder due to another medical condition
- Trichotillomania (hair-pulling disorder; has been moved from “impulse-control disorder not elsewhere classified”)
Obsessive Compulsive Disorder (OCD)
Characterized by unwanted, intrusive, unreasonable egodystonic urges (obsessions) that create sx of anxiety, and are resolved with a compulsion that relieves the symptoms. In other words, the patient has urges that create symptoms of anxiety that can only be resolved by a certain compulsion
- Common obsessions
- Germs
- Organization
- Counting
- Checking
- Differentials
- Impulse-control disorder: urges are egosyntonic (Kleptomania, pyromania)
- OCPD: rational, but disproportionate, fixation of perfection, scrupulousness; Egosyntonic (not similar at all in terms of Sx)
- Treatment
- Biological
- SSRIS
- Psychotherapy
- Relaxation therapy
- Exposure therapy
- CBT
- Biological
Body Dysmorphic Disorder
Characterized by preoccupation with a specific body part(s), believing that it is misformed or abnormal, despite convincing and objective evidence that it is not. Frequently comorbid with anxiety disorders (esp. OCD)
- Parts commonly involved
- Skin
- Hair
- Nose
- Weight
- Differentials
- Delusional disorder, somatic type. dx if preoccupation is bizarre
- Anorexia nervosa: pt wrongly views self as overweight AND shows signs of malnutrition (BMI <17.5)
- OCD: The patient will engage in a compulsion to relieve anxiety about the body part
- Treatment
- Individual psychotherapy (mainstay)
- SSRIs