Testing only

1. OBSESSIVE COMPULSIVE
DISORDER ( 强迫症 )
By Dr. Phang Cheng Kar (M.D.)
Senior Medical Lecturer & Psychiatrist,
Universiti Putra Malaysia (UPM)

2. Disclaimer…
 This power point presentation is part of a FREE educational talk
delivered in KL Buddhist Mental Health Association (BMHA) by
Dr. Phang Cheng Kar.
 The materials can be reused without permission as long as it’s
for educational, non-commercial purpose & with good intention.
 This should NOTbe used as substitute for consultation with
medical or mental health professionals.

3. Contents…
Sig
S
g ns
S
n
ig &
s Tre
Ca
sy
n
&
s at
use
mp
s
y
& me
s&
to
m
s nt
co
ms
y
p
m
–
ndi
p me
tio
Q
o
m
t dic
nin
&
o ati
s
m gs
A,
s on
e.g
&
.
psy
wh
ch
ere
olo
to
gic
get
al
Rx

4. Signs & symptoms…
 OBSESSION
- Repetitive thoughts, images or impulse
- Distressing or anxiety provoking
- Ridiculous or non-sensical
 COMPULSION
- Mental or physical rituals
- To neutralize an obsession
- Excessive & interfere with life

5. Different themes of OCD…
OBSESSION COMPULSION
 Contamination  Cleaning & washing
 Symmetry  Checking
 Aggression  Repeating
 Sexual  Counting
 Religious  Confessing
 Somatic  Arranging
 Hoarding  Reassurance
 Miscellaneous  Miscellaneous

6. A
n
O
 Check door
C
 Wash hands
D
 Flush toilet
‘
 Repeat
T
 Repeathagain
 Repeati again, once more
n
 Repeat again, once more, another
g
time…
s
-

7. Different themes of OCD - %
Source
W OBSESSION COMPULSION
e
st  Contamination: 32.9%  Checking: 28.1%
w
o  Aggression: 16.6%  Cleaning/Washing: 25.9%
o
d  Need for Exactness: 8.5%  Mental: 11.5%
n
st
 Religious: 6.3%  Repeating: 11.0%
t  Somatic: 6.2%  Ordering/Arranging: 5.3%
u
 Sexual: 5.3%  Hoarding/Collecting: 3.2%
e
 Hoarding/Saving: 4.0%  Counting: 2.6%
o
N
 Miscellaneous: 20.2%  Miscellaneous: 12.4%
A o
n t

8. si
u
p
m
o
e
x
nil
y y
a
r
o
p
m
e
e e
m s
O OCD pcycle… s
b
o A
s i
e
r n
s o
si
a x
n
o
n r C i
y o e
m t
R y
e p
li u
e l
f s
i
o

9. Cause of OCD…
 Genetics
Neurotransmitter imbalance, e.g. serotonin
OCD Brain - ‘short circuit’
 Thinking errors, e.g. need to be 101% sure
 Brain damage, e.g. certain type of dementia
 Infection during childhood, e.g. PANDAS
 Stress & other psychological factors – worsen OCD (not direct
causation)

10. A
OCD Brain - the danger ALARM is on 24
n
t
hours a day…
O
e
ri
r o
bi r O
t C
in
C r
al a
C g b
u
A
o ul
d i
rt a
m t
a t
e t
y
x e a
g e
d
G
n l
y
al r
u C
a cl o
u
e
s
u r
s t
e
S
x
So –

11. The worrying OCD brain…
H
y
p
e
r
a
c
t
i
Source v
:

12. A compulsive OCD brain…
S
o
ur
ce
:
ht
tp
://
w
w
w.
sc
ie
nc
e
d
ail
y.
co
m
/r
el
S ea
ci se
s/
e
20
n 0

13. Thinking errors in OCD…
 Thoughts are over-valued.
("If I keep thinking this, it must be really important.")
Doubt is translated into actual danger.
("Thinking it is dangerously close to doing it. If I keep thinking it, I must be getting closer to doing it.")
Thought content must be controlled.
("I've got to use will power!")
Total certainty is not only possible but imperative.
("How can I be absolutely sure I won't….")
Need to avoid culpability.
("If I'm careful enough, I can't be held responsible for bad things.")
Magical power to keep things from happening.
("If I can control this bad thought, my loved ones will be safe.")
Wish to erase all risk.
("If I'm careful enough, I can control the risk.")
S

14. Treatment – SSRI Medications…
S
S
o
o
u
rc  Click to edit Master text style
u
rc
e:
W e:Second level
P
ik ixThird level
ip
a ▪ Fourth level
e
b
di ▪ Fifth level
a
a
y
c
o
m
m
o
Sn
S

15. Calming the OCD mind…
R
e
d
u
ct
"
io H
n
in a
c
a v
u
d
i
a n
t
e g
n
u
cl
S
e ource
O

16. Psychological Rx of OCD – ‘MR5’
Relabeling – it’s OCD, not me
Refocus – distraction
Relaxation – fun, yoga, qi gonq, meditation
Restraint – exposure & response prevention
Revalue – the good side of OCD, e.g. creativity & responsible
 MINDFULNESS
- Do it ONCE but with all senses focusing on he ‘here-and-now’
- Urge surfing
- Cognitive defusion

17. Further readings…
 OCD Websites
http://www.geonius.com/ocd/
 International OCD Foundation
http://www.ocfoundation.org/
 OCD Online
http://www.ocdonline.com/defineocd.php
 Dealing with OCD
http://www.anxietyandstress.com/dealingwithocd.html

18. THANK YOU…
I hope I didn’t say anything wrong that will harm you (318 X)

19.  Yale-Brown Obsessive Compulsive Scale

20. Themes of OBSESSION…

21. Contamination

22. Symmetry

23. Aggression

24. Sexual

25. Religious

26. Somatic & hoarding…

27. Miscellaneous

28. Themes of COMPULSION…

29. Cleaning & washing…

30. Checking…

31. Repeating & counting…

32. Arranging & hoarding…