Category: Ocd - Beyond The Body

Beyond The Body

Think Like A Psychiatrist - A Child With Self-Injurious Behaviour

3/2/2017

Put your knowledge and skills to the test with the case of patient A, a 6 year old child, who is brought to your office due to a repetitive self-injurious behaviour in which she repeatedly jams her finger into her nose, leading to multiple nosebleeds per day.

Based on additional history, you determine that these symptoms began at age 3, and are associated with multiple fears (vomiting, storms, public bathrooms, parents' dying), bedtime checking rituals, and involuntary motor and vocal tics such as facial grimacing and throat clearing. She has recurrent UTIs, but is otherwise healthy. There is no history of trauma/abuse. She has been receiving CBT for the last year, and is not on any meds.

What diagnoses are on your differential? What further information would help you distinguish between these diagnoses? What treatment would you suggest?

"A girl repeatedly jabs her finger up her nose: Compulsion or self-injury?" by Butkus M and Vinch J (Current Psychiatry).

New Research Findings May Lead to Better OCD Treatments

7/25/2016

Researchers at Duke University have made a significant advancement in understanding ‪‎OCD‬, as they announced last Friday that they have identified a receptor in the ‪‎brain‬ that may cause the disorder. Though their research was originally conducted in mice, it opens doors for the development of new more targeted and likely more effective medications and treatments ...

"When comparing regular mice to mice that lacked the Sapap3 gene, researchers discovered that the mice without it often had an overactive direct pathway, seemingly explaining why they are so prone to repeating the same actions over and over. When scientists did even more digging, they realize that a specific chemical receptor, called mGluR5, was consistently active in the brains of the mice who lacked Sapap3. This finding suggests that mGluR5 may control the hyperactivity of the brain circuits that coordinate action, thus possibly explaining why so many people with OCD have both obsessive thoughts and obsessive actions."

To read more about the study click here:
http://www.bustle.com/…/173805-what-causes-ocd-scientists-m…
http://thescienceexplorer.com/…/researchers-find-switch-ocd…

For the original abstract click here:
http://www.biologicalpsychiatryjournal.com/…/S0006…/abstract

The New Field of Psychosurgery

7/1/2015

Treatments for mental illnesses often include psychotherapy, psychotropic medications, and even ECT and deep brain stimulation ... but what about surgery‬? Termed psychosurgery‬, a new field is evolving that offers treatment to those who have failed other forms of therapy. Take a read of the article, "Psychosurgeons Use Lasers to Burn Away Mental Illness" to learn about this new specialty and see how some physicians are using it to help those with OCD ...

"This is the shape of modern psychosurgery: Ablating parts of the brain to treat mental illnesses. Which might remind you of that maligned procedure, the lobotomy. But psychosurgeries are different. And not just because the ethics are better today; because the procedures actually work. Removing parts of a person’s brain is always a dicey proposition. But for people who are mentally ill, when pills and psychiatry offer no solace, the laser-tipped probe can be a welcome relief."

Good Reads: The Crazy Game

1/29/2015

In an interview in October with Jian Ghomeshi, former NHL goalie Clint Malarchuk opens up about his struggles with depression, OCD, PTSD, and alcoholism, and shares how hockey was his escape from mental illness‬.

In the interview (link to video here), Malarchuk also discusses his new memoir "The Crazy Game" which he hopes will help fight against the stigma of mental illness and encourage more people to talk about mental health ...

Recommended For:
Hockey fans and those interested in mental health

Lena Dunham talks about OCD, anxiety, and where she's at now with her mental health

10/16/2014

Lenha Dunham, creator, writer and star of the hit HBO series Girls, talks with CBC's Jian Ghomeshi about growing up with obsessive-compulsive disorder and discusses how she currently manages her anxiety and sleep disorder. To watch the interview, follow the link https://www.youtube.com/watch?v=vsnqEJ924Ho or watch the video below:

Dermatillomania - Part 2

6/19/2014

For a brief synopsis of dermatillomania or skin picking disorder, including what it is, the basic facts about the disorder, the prevalence, the gender distribution, and common therapies utilized to aid in recovery, check out the great infographic below from skinpick.com!

All You Need to Know about Dermatillomania

Dermatillomania - Part 1

6/18/2014

Dermatillomania, also known as excoriation disorder or skin-picking disorder, was first officially recognized as a psychiatric disorder in the most recent version of the DSM, the DSM-5. It is currently classified under the category of obsessive-compulsive and related disorders, and is "characterized by the repetitive and compulsive picking of skin, leading to tissue damage" (American Journal of Psychiatry). The face, arms and hands are the most commonly involved areas, and individuals affected with this disorder may pick/squeeze/rub/bite at healthy skin, or minor skin imperfections or lesions like acne (DSM). The onset of skin picking disorder can vary from childhood into adulthood, however for many it begins during puberty in adolescence.

Trichotillomania - Part 2

6/10/2014

To gain further insight into trichotillomania, check out the short 20 minute documentary "Girls On The Pull" which follows three young women from the UK who are affected by this mental health condition. In the documentary, the women bravely show the cameras how this disorder has physically affected them, in addition to providing an intimate portrayal of what it's like living with and experiencing trichotillomania including how it's affected their families, what it feels like, what they believe may have led to the development of the disorder, and the treatments they have tried in an effort to recover and move forward.

Trichotillomania - Part 1

6/9/2014

Trichotillomania is a lesser known and less common mental health condition that falls under the category of obsessive-compulsive and related disorders in the latest version of the DSM. It is "characterized by the persistent and excessive pulling of one’s own hair, resulting in noticeable hair loss" (Medscape). The scalp, eyebrows and eyelashes are the most commonly involved areas, but the hair-pulling can occur anywhere on the body where hair grows. Though it is thought to only affect 1-2% of the population (DSM-5), and females are affected more than males by a ratio of 10:1, it can be a particularly devastating disorder.

To get a better understanding of what it's like to have trichotillomania, check out the article "From Hair Puller to Hairdresser: Kelsie’s Life With Trichotillomania" by Kelsie Hanna, a truly powerful account of one person's experiences with this condition.

To read more personal stories of those with trichotillomania, see:

"Woman hopes her experience with hair-pulling disorder will help others" (Global News)
"Trichotillomania a True Medical Mystery" by Juju Chang (ABC News)

Recreational Drugs as Psychotherapy Part 2 - Ketamine

6/5/2014

Ketamine has been used for years both in veterinary medicine, as well as in human medicine as an anesthetic. Many also buy the drug illicitly, which is better known as 'Special K' or 'Vitamin K' on the streets, to use for recreational purposes. At subanesthetic doses, the substance causes a short-lived dissociative state which involves distortion of perceptions of sight and sound, hallucinations, and a dream-like feeling or out of body experience. Ketamine, sometimes also receives a bad-rap as its one of the top 3 date rape drugs next to Rohypnol and GHB.

More recently though, ketamine has been the subject of investigation and research to determine whether it may have some utility and efficacy in treating mental illness. While preliminary research has shown that it may be promising for use in depression, many countries are now investigating its use further for mood disorders, as well as for other mental health conditions including OCD, PTSD, alcoholism and drug addiction.

For more information about some of the research on ketamine and mental illness check out these articles:

"Ketamine's Rapid Effects in Depression and OCD: Cause for Hope and Caution" by Carolyn Rodriguez (Huffington Post)
"Intranasal Ketamine Promising For Treatment-Resistant Major Depression" by Robert Glatter (Forbes)
"'Club Drug’ Ketamine Lifts Depression in Hours" by Maia Szalavitz (Time)
"PTSD, alcoholism might be treatable with ‘magic drug,’ Yale researchers say" by Lisa Chedekel (The Denver Post)
"Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up" by Krupitsky E, Burakov A, Romanova T, Dunaevsky I, Strassman R, and Grinenko A. (Journal of Susbtance Abuse Treatment)