EpistemisObsessions
Specialty: Psychiatry.
Why it occurs
- Obsessive-compulsive disorder (OCD)
- Obsessive-compulsive personality disorder (OCPD)
- Body dysmorphic disorder
- Schizophrenia (transitional obsessive phenomena)
- Post-traumatic stress disorder
- Dementia or frontotemporal lobar degeneration
Initial workup
Yale-Brown Obsessions and Compulsions Scale (Y-BOCS); general cognitive evaluation (MoCA or MMSE) if it appears at advanced ages to rule out dementia prodromes.
red flags
Obsessions with autolytic, infanticidal or aggressive content with a high level of existential anguish, or that completely prevent falling asleep or eating.
Standard management
- Sertraline — SSRI at high doses, requires progressive titration
- Clomipramine — tricyclic antidepressant with powerful serotonergic action, very effective in refractory OCD
- Fluvoxamine — SSRI with excellent profile for obsessive symptoms
- Aripiprazole or Risperidone at low doses — as enhancers of SSRIs in resistant cases
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4