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Transcript of OCD
Austin Korn Howard Hughes: Patient Evaluation and Explanation of OCD Do you have repetitive thoughts that make you anxious and that you cannot get rid of regardless of how hard you try?
Do you keep things extremely clean or wash your hands frequently?
Do you check things to excess? Please Answer the Following... Leonardo Dicaprio Charlie Sheen
Martin Scorsese David Beckham
Justin Timberlake Michael Jackson
Cameron Diaz Donald Trump
Penelope Cruz Charles Darwin
Jessica Alba Justin Beiber
Howie Mandel Albert Einstein
Michelangelo Ludwig Van Beethoven Did You Know? http://www.disabled-world.com/artman/publish/famous-ocd.shtml "Obsessive-compulsive disorder is characterized by obsessions (intrusive, repetitive thoughts or images that produce anxiety) or compulsions (the need to perform acts or to dwell on thoughts to reduce anxiety)."
Pg 102 What is OCD? don't know where to find help/treatment
intimidating Reasons for NOT Seeing a Therapist "Obsessive-compulsive disorder is relatively common; however, its actual incidence has only recently become clear.
The neurotransmitter serotonin appears to have a central role in this disorder.
Males and females are affected equally, with onset usually occurring in late adolescence.
Symptoms include intrusive thoughts that lead the patient to perform repetitive rituals that interfere with daily living.
Although patients are typically distressed by these thoughts and rituals, they seldom volunteer their symptoms.
At one time considered rare, obsessive-compulsive disorder is now recognized as relatively common, exceeding the lifetime prevalence of more visible disorders such as schizophrenia.1,2"
Recognition and Treatment of Obsessive-Compulsive Disorder MARK F. EDDY, PH.D., and GORDON S. WALBROEHL, M.D., Wright State University School of Medicine, Dayton, Ohio Am Fam Physician. 1998 Apr 1;57(7):1623-1628. More About OCD Youth:
Paralysis of legs
Multiple plane crashes
Most fatal at 1946
clip Medical History of the Patient BIOLOGICAL
possible genetic component but specific genes
not yet identified
may stem from behavior-related habits over time
INSUFFICIENT LEVELS OF SEROTONIN
people who have taken medications that improve
serotonin activity have shown to improve OCD symptoms "Hughes's germ phobia revealed in psychological autopsy"
American Psychological Association July 2005, Vol 36, No. 7 Diagnosis: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Axis I: Clinical Disorders – Anxiety Disorders Axis II: Personality disorders and mental retardation – Paranoid Personality (clip 2:33:55-2:34:56) Axis III: General medical condition – Contracted syphilis. Constant pain after crash. (clip 1:43:23-1:44:03) Axis IV: Psychosocial and environmental problems
Problems related to social environment
Problems related to interaction with legal system/crime Diagnosis: Axis V: Global assessment of function Beginning of movie:
70: Mild symptoms OR difficulty in social occupational function End of movie:
20: Some danger of hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication Behavioral Treatments: Exposure & Response Prevention Either by flooding or gradually exposing patient to actual or imaginary fear arousing situations Treatment Plans Biological Treatments: antidepressant medications such as fluoxetine and clomipramine http://www.mclean.harvard.edu/news/press/current.php?id=67 Prognosis Howard Hughes was considerably worsening as time progressed. During his era OCD was a rare diagnosis. The chances he would receive effective treatment are unlikely. The illness continued to debilitate him until he became a recluse and died in 1976. 1940-1970's - Eccentric Hospitalization for several weeks
Treated with medication
Behavior therapy to identifying target obsessions, compulsions & avoidance
Begin response-prevetion Treatment Plan Modern Day Prognosis Hughes would receive medical & therapeutic treatment that would allow him to function in society with less drastic symptoms. The likelihood that he would be cured is doubtful. Compulsive - very clear, well shown
Obsessive - could have gone into further detail on what his triggers were Movie - Depicting Disorder Allene Hughes Psychosocial History As a Child Psychosocial History Peas were one of the few vegetables he would eat, but he only liked small ones. Large peas he considered inedible Howard invented a device by which he could measure the size of peas and separate the larger ones from the smaller ones. Would sometimes remove Howard from a school or summer camp because of sudden fear of him contracting diseases. Died in March 1922 from complications of an ectopic pregnancy. Howard Hughes Sr Psychosocial History Died of a heart attack in January
1924 Patented the two-cone roller bit Founded the Hughes Tool Company in 1909 Young Howard Psychosocial History Built Houston's first radio transmitter at 11 years old Built Houston's first motorized bicycle, from parts taken from his father's steam engine The death of his parents inspired Howard to
include the creation of a medical research laboratory in his will that he signed
when he was 19. Drug and Alcohol History died of codeine poisoning insomniac: Seconal's active ingredient is called secobarbital. It is a barbiturate that is classified as a sedative-hypnotic, meaning it acts as a depressant and makes you feel sleepy. Librium (Chlordiazepoxide) is used to relieve anxiety and to control agitation caused by alcohol withdrawal. Germs Behavioral Observations cellophane on steering wheel Constantly washing his hands "something on your suit" Disgusted when his food is touched Attention to Detail Behavioral Observations Hell's Angels was originially a silent film Hughes almost doubled the original cost of the movies by requiring
the movie to be reshot with sound, making Hell's Angels a $3.8
million dollar prouction Odd Behavior Behavioral Observations Chocolate Chips Milk Repeats Words Microphones Camera Shy Charming around women Behavioral Observations Always caught up in work (dinner scene) Awkward at times Appearance
Mood and Affect
Mental Status Examination Before/After Functional Assessment