OCD: The Daily PANCE Blueprint

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OCD: The Daily PANCE Blueprint

A 38-year-old female with a history of depression, hypertension, and hypothyroidism presents to the clinic saying she needs help. She says she is very anxious about getting dirty hands and has a compulsion to wash her hands every few minutes or else she becomes more distressed. She tries to distract herself but continues to obsess about clean hands. Which of the following is the best treatment option for the most likely diagnosis?

A. SSRIs and cognitive behavioral therapy
B. Anti-psychotics and habit-reversal technique therapy
C. Benzodiazepines and anti-psychotics
D. Acceptance and commitment therapy
E. Benzodiazepines only

Answer and topic summary

The answer is A. SSRIs and cognitive behavioral therapy

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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