OCD: explaining and treating (Biological approach) - Psychopathology [A-Level Psychology]

Summary

This script delves into the biological aspects of OCD, a condition often misunderstood as mere tidiness. It clarifies OCD's debilitating nature with intrusive thoughts and compulsions, and explores its genetic roots, candidate genes, and neural mechanisms involving serotonin. The video also evaluates treatments, emphasizing SSRIs' effectiveness and the potential role of environmental factors, suggesting a combination of biology and environment in OCD's development.

Takeaways

• 🧠 OCD is a mental health condition that is often misunderstood; it is not merely about being tidy or organized.
• 🤔 The condition is characterized by intrusive thoughts and repetitive behaviors that cause significant distress and anxiety.
• 🧬 There is a genetic component to OCD, with certain 'candidate genes' being more common in affected individuals.
• 👨‍👩‍👧‍👦 Family studies show a higher prevalence of OCD among first-degree relatives, suggesting shared genetic factors.
• 🧬👭 Identical twins have a higher concordance rate for OCD than non-identical twins, indicating a strong genetic influence.
• 🧪 The serotonin system in the brain, particularly the SERT gene, is implicated in the development of OCD.
• 💊 SSRIs are a common pharmacological treatment for OCD, working by increasing serotonin levels in the brain.
• 🧠🔄 The 'worry circuit' in the brain, involving areas like the orbito-frontal cortex and basal ganglia, is overactive in OCD.
• 🔍 Neuroimaging studies have shown hyperactivity in certain brain regions associated with OCD.
• 🌐 The diathesis-stress model suggests that a genetic predisposition to OCD may require an environmental stressor to manifest.
• 💊💰 Drug therapy for OCD is generally less expensive and more accessible than psychological therapies like CBT.

Q & A

What is OCD and why is it often misunderstood?

OCD, or obsessive-compulsive disorder, is a mental health condition characterized by repetitive and intrusive thoughts causing anxiety, and the need to perform behavioral compulsions. It's often misunderstood because people casually attribute the term to individuals who are exceptionally organized or prefer routine, which minimizes the severity of the actual disorder.

How do the symptoms of OCD manifest?

Symptoms of OCD include obsessive thoughts, which are mental images, worries, or urges that cause anxiety, and compulsions, which are behaviors performed to temporarily relieve the anxiety caused by these thoughts. Common obsessions include fears of dirt leading to excessive cleaning, concerns about burglary leading to repeated checking of locks, and worries about causing a fire leading to repeated checking of power switches.

What is the genetic explanation for OCD?

The genetic explanation suggests that a predisposition to OCD is inherited. While there isn't a single 'OCD gene', there are 'candidate genes' like the gene 9, COMT gene, SERT gene, and 5HT1-D beta gene that are more frequently found in individuals with OCD. OCD is considered polygenic, with up to 230 genes potentially involved.

How do family studies support the genetic origin of OCD?

Family studies indicate a higher prevalence of OCD among first-degree relatives of individuals with OCD, known as the concordance rate, which rises to 10% compared to 2% in the general population. Identical twins (monozygotic twins) have a 68% concordance rate for OCD, while non-identical twins (dizygotic twins) have a 31% rate, suggesting a genetic component.

What is the role of neurotransmitters in OCD?

Neurotransmitters, particularly serotonin, play a key role in OCD. Low levels of serotonin are thought to cause obsessive thoughts, potentially due to it being removed too quickly from the synapse before it can transmit its signal. The SERT gene, responsible for serotonin transportation in the synapse, is implicated.

What brain structures are involved in the neural explanation of OCD?

The 'worry circuit' in the brain, which includes the orbito-frontal cortex, the basal ganglia (specifically the caudate nucleus), and the thalamus, is overactive in people with OCD. This overactivity leads to an inability to filter out small worries, resulting in recurring obsessive thoughts.

How do evaluations of genetic factors in OCD consider environmental influences?

Evaluations consider the diathesis-stress model, suggesting individuals inherit a genetic vulnerability (diathesis) to OCD, but the disorder develops only with an environmental stressor, such as a traumatic life experience. This is supported by research showing a correlation between traumatic life events and increased severity of OCD symptoms.

What is the effectiveness of drug therapies like SSRIs in treating OCD?

SSRIs, or selective serotonin reuptake inhibitors, are antidepressant drugs used to control OCD symptoms by normalizing the activity of the worry circuit. A meta-analysis by Soomro showed SSRIs to be more effective than placebos, suggesting a biological aspect to OCD treatment.

What are the limitations of drug therapies for OCD?

Drug therapies like SSRIs may not be effective for all patients, can take up to three to four months to impact symptoms, and may only treat symptoms rather than the cause. Additionally, they can have side effects and there is criticism regarding the reliability of research funded by pharmaceutical companies.

Why might psychological therapies like CBT be preferred over drug therapy for some OCD patients?

Psychological therapies like CBT (Cognitive Behavioral Therapy) may be preferred as they potentially address the root cause of OCD rather than just the symptoms. They can be more effective in the long term, despite being more expensive and time-consuming than drug therapies.

What economic factors influence the choice between drug therapy and psychological therapies for OCD?

Drug therapy is often chosen over psychological therapies like CBT due to its relatively lower cost and convenience. However, the potential for side effects and the possibility of only treating symptoms rather than the cause may influence some patients to opt for psychological therapies despite their higher cost.