Obsessive-Compulsive Disorder: The Daily PANCE Blueprint

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Obsessive-compulsive disorder: The Daily PANCE Blueprint

A 25-year-old male presents to the clinic with recurrent thoughts about being contaminated and spends several hours a day washing his hands to "feel clean." He recognizes these behaviors are excessive but feels compelled to continue. Which of the following is the most appropriate first-line treatment approach?

A. Benzodiazepines and supportive therapy
B. Cognitive behavioral therapy and selective serotonin reuptake inhibitor
C. Electroconvulsive therapy
D. Antipsychotics and psychoanalysis
E. Serotonin-norepinephrine reuptake inhibitor alone

Answer and topic summary

The answer is B. Cognitive behavioral therapy and selective serotonin reuptake inhibitor

The patient has obsessive-compulsive disorder (OCD), which is defined by recurrent intrusive urges (obsessions) that cause anxiety or distress and repetitive acts (compulsions) that the patient feels like they have to perform. Both genetics and the environment contribute to the etiology. The DSM-V criteria should be used to confirm the diagnosis. Examples of obsessions include perfectionism, religious obsession, losing control, and contamination; examples of compulsions include washing/cleaning, checking, repeating activities, etc. Management often includes both SSRIs and cognitive behavioral therapy (exposure-response therapy). Some patients may respond just to SSRIs.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Obsessive-compulsive and related disorders (PEARLS)

Also covered as part of the Psychiatry and Behavioral Health Rotation topic lists

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