Obsessive-Compulsive and Related Disorders MCQs

Anna Freud described 10 defence mechanisms in her work. Reaction formation projection and regression are three of them. In displacement, emotions or wishes are transferred from the original object or person to a more suitable substitute. ( Option A is CORRECT ) Reaction formation is seen in patients with obsessive–compulsive disorder . ( Option D ) Here the attitude is opposed to the oppressed wish and constitutes the opposite reaction Projection : unacceptable thoughts, emotions and feelings are projected on to some other person ( Option C ) Identification : a person takes the attributes of others to him or herself ( Option B ) Reference: Synopsis of Psychiatry, eleventh edition, chapter 4, page no. 161

Treatment is more effective if compulsions are present . Cognitive and behavioural therapies have similar effectiveness to SSRIs. (Option A) Likewise, group and individual therapies have similar success rates. (Option B) Patients with more bizarre obsessional thoughts are less likely to resist carrying out compulsive acts. The frequency of psychotherapy sessions has not been shown to influence outcome although duration of each session and the therapy overall is associated with better outcomes. (Option C) Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 10, page no. 423

Ans. C i.e. Severe depression 1458. Repetitive irresesistable thought to do something a) Phobia b) Obsession c) Compulsion d) Anxiety Correct Answer - B Ans. is 'b' i.e., Obsession Obsessive compulsive disorder (OCD) OCD is an anxiety disorder which is characterized by recurrent, unwanted thoughts (Obsessions) and repettive behaviors (compulsions). An obsession has following characteristic : -

Obsessions are repetitive, intrusive thoughts that are recognised as irrational thoughts by the sufferer. Several unsuccessful attempts have been made to resist these thoughts. The content of the thought can be related to aggression, dirt, contamination, fear of causing harm, and religious or sexual thoughts. In order to reduce the associated anxiety symptoms patients, carry out repetitive acts such as counting, cleaning repeatedly, or touching or arranging things in symmetry; These acts are termed ' compulsions' . Reference: PGNIP2, Cijo Alex, 2 nd Edition, Chapter 3, page no. 28

The mean age of onset for OCD is 20 years . Social phobia typically begins to develop after puberty. Features of Asperger’s syndrome are commonly noted from the age of three or earlier. The majority of females with anorexia nervosa have on set within five years of menarche. Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 10, page no. 419

Predominance of phobic ruminative ideas and absence of compulsions is favourable prognostic factor . ( Options A, B & C are all true ) Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 10, page no. 420

Explanation: Contamination/Cleansing is the most commonly seen pattern of obsession Obsessive-Compulsive Disorder (OCD) A disorder characterized by intrusive thoughts (obsessions) and repetitive behaviours (compulsions). Symptoms: Obsessions: Unwanted thoughts or urges causing anxiety (e.g., contamination fears, doubts). Compulsions: Behaviours performed to alleviate anxiety (e.g., excessive washing, checking). Common Patterns: Contamination/Cleansing: Fear of germs leading to compulsive washing. Pathologic Doubt/Checking: Doubts about safety (e.g., turning off appliances). Intrusive/Forbidden Thoughts: Distressing thoughts about aggressive or sexual acts. Symmetry/Ordering: Compulsion for order or symmetry. Insight: Most patients recognize their beliefs are irrational, but some have poor or no insight.

OCD related disorders: UPDATES: ICD-11 & DSM-5 Hoarding disorder Body dysmorphic disorder (Dysmorphophobia) Olfactory reference syndrome Body focused repetitive behavior disorder: Trichotillomania Excoriation (skin-picking) disorder Hypochondriasis (as per ICD-11)DSM-5 : It is Somatic (a/c Illness anxiety disorder) Reference: ICD-11, Obsessive Compulsive and related disorder, BlockL1-6B20, Page No.: 43-47