Obsessive-Compulsive and Related Disorders Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Obsessive-Compulsive and Related Disorders. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Obsessive-Compulsive and Related Disorders Indian Medical PG Question 1: Drug most useful in the treatment of obsessive compulsive disorder is
- A. Doxepin
- B. Fluoxetine (Correct Answer)
- C. Dothiepin
- D. Amoxapine
Obsessive-Compulsive and Related Disorders Explanation: ***Fluoxetine***
- **Fluoxetine** is a **selective serotonin reuptake inhibitor (SSRI)**, which are considered first-line treatments for **obsessive-compulsive disorder (OCD)**.
- SSRIs, including fluoxetine, are effective in **reducing the severity of obsessions and compulsions** by increasing serotonin levels in the brain.
*Doxepin*
- **Doxepin** is a **tricyclic antidepressant (TCA)** that primarily blocks the reuptake of norepinephrine and serotonin but also has significant anticholinergic and antihistaminic properties.
- TCAs are generally **less preferred for OCD** due to their side effect profile and **SSRIs** typically showing greater efficacy.
*Dothiepin*
- **Dothiepin** is also a **tricyclic antidepressant (TCA)** with similar mechanisms and side effects to doxepin.
- Like other TCAs, dothiepin is **not a first-line treatment for OCD**; SSRIs are more commonly used due to better tolerability and efficacy.
*Amoxapine*
- **Amoxapine** is a **tetracyclic antidepressant** with properties similar to TCAs, also acting as a **norepinephrine and dopamine reuptake inhibitor**.
- While it has antidepressant effects, amoxapine is **not typically used for OCD** and carries a risk of inducing extrapyramidal side effects.
Obsessive-Compulsive and Related Disorders Indian Medical PG Question 2: Drug of choice for obsessive-compulsive disorder
- A. Haloperidol
- B. Buspirone
- C. Olanzapine
- D. Fluoxetine (Correct Answer)
Obsessive-Compulsive and Related Disorders Explanation: ***Fluoxetine***
- **Selective serotonin reuptake inhibitors (SSRIs)** like fluoxetine are considered **first-line pharmacological treatment for Obsessive-Compulsive Disorder (OCD)** due to their effectiveness in modulating serotonin pathways implicated in the disorder.
- Multiple SSRIs (fluoxetine, fluvoxamine, paroxetine, sertraline) and clomipramine are equally effective first-line agents, but **SSRIs are preferred initially** due to better tolerability and safety profile.
- Among the given options, fluoxetine is the appropriate choice as an established first-line SSRI for reducing the frequency and intensity of obsessions and compulsions.
- **OCD typically requires higher doses and longer duration** (8-12 weeks) compared to depression treatment.
*Haloperidol*
- **Haloperidol** is a **first-generation antipsychotic** primarily used to treat psychotic disorders (e.g., schizophrenia) and severe behavioral disturbances.
- It works by blocking **dopamine D2 receptors** and is not a first-line treatment for OCD, though it might be used as an **augmentation strategy** in severe, treatment-refractory cases, particularly when tic disorders coexist.
*Buspirone*
- **Buspirone** is an **anxiolytic** primarily used for generalized anxiety disorder (GAD). It acts as a **serotonin 5-HT1A receptor partial agonist**.
- While it helps with generalized anxiety, it is **generally ineffective** for the specific obsessions and compulsions characteristic of OCD and is not recommended as monotherapy.
*Olanzapine*
- **Olanzapine** is a **second-generation antipsychotic** primarily used for schizophrenia and bipolar disorder. It blocks dopamine and serotonin receptors.
- It is not a first-line treatment for OCD but can be used as an **adjunct to SSRIs** in severe, treatment-resistant cases, particularly when there is partial response to adequate SSRI trials or comorbid psychotic symptoms.
Obsessive-Compulsive and Related Disorders Indian Medical PG Question 3: Body dysmorphic disorder can be associated with all except
- A. Bulimia nervosa
- B. OCD
- C. Anxiety
- D. Mania (Correct Answer)
Obsessive-Compulsive and Related Disorders Explanation: ***Mania***
- **Mania** is a state of elevated, expansive, or irritable mood that is distinct from the persistent preoccupation with perceived bodily defects seen in **body dysmorphic disorder (BDD)**.
- While agitation can occur in BDD, the core symptom profile of **mania**, including decreased need for sleep, grandiosity, and racing thoughts, is not a typical associated feature.
*Bulimia nervosa*
- **Bulimia nervosa** can co-occur with BDD, particularly when the perceived defects relate to body weight, shape, or specific body parts.
- Both disorders involve intense preoccupation with body image and often lead to harmful behaviors to attempt to "correct" perceived flaws.
*OCD*
- **Obsessive-compulsive disorder (OCD)** shares strong phenomenological similarities with BDD, including intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
- BDD is often conceptualized as part of the **OCD spectrum**, with both disorders involving obsessive thoughts and repetitive behaviors related to specific concerns.
*Anxiety*
- **Anxiety disorders** are highly comorbid with BDD, as individuals often experience significant distress, fear of judgment, and social avoidance due to their perceived flaws.
- The constant preoccupation and efforts to conceal or fix perceived defects can lead to chronic anxiety and panic attacks.
Obsessive-Compulsive and Related Disorders Indian Medical PG Question 4: Which of the following treatments cannot be used for management of Obsessive Compulsive Disorder (OCD)?
- A. Fluoxetine
- B. Carbamazepine (Correct Answer)
- C. Cognitive Behaviour Therapy
- D. Clomipramine
Obsessive-Compulsive and Related Disorders Explanation: ***Carbamazepine***
- **Carbamazepine** is an **anticonvulsant** and **mood stabilizer** primarily used for epilepsy and bipolar disorder.
- It does not have established efficacy for the treatment of **Obsessive-Compulsive Disorder (OCD)**.
*Fluoxetine*
- **Fluoxetine** is a **Selective Serotonin Reuptake Inhibitor (SSRI)** and is a **first-line pharmacotherapy** for OCD.
- SSRIs, including fluoxetine, are effective in reducing the severity of **obsessions and compulsions**.
*Cognitive Behaviour Therapy*
- **Cognitive Behavioural Therapy (CBT)**, specifically **Exposure and Response Prevention (ERP)**, is the **gold standard psychotherapy** for OCD.
- It involves gradually exposing patients to feared situations or thoughts while preventing their ritualistic responses.
*Clomipramine*
- **Clomipramine** is a **tricyclic antidepressant (TCA)** that has potent inhibitory effects on **serotonin reuptake**.
- It is one of the **most effective medications** for OCD, often used when SSRIs are insufficient.
Obsessive-Compulsive and Related Disorders Indian Medical PG Question 5: Which of the following conditions does not typically involve delusions?
- A. Delirium
- B. Alcohol withdrawal
- C. OCD (Correct Answer)
- D. Schizophrenia
Obsessive-Compulsive and Related Disorders Explanation: ***OCD***
- **Obsessive-compulsive disorder** is characterized by recurrent, intrusive **thoughts (obsessions)** and repetitive **behaviors (compulsions)**, which the individual typically recognizes as irrational.
- While patients with severe OCD may have **poor insight**, they generally do not experience **delusions**, which are fixed, false beliefs held despite evidence to the contrary.
*Delirium*
- **Delirium** is an acute, fluctuating disturbance of consciousness resulting from medical conditions or substance intoxication/withdrawal, often accompanied by **psychotic symptoms** including **delusions** and **hallucinations**.
- The rapid onset and global cognitive impairment make **delusions** a common feature.
*Schizophrenia*
- **Schizophrenia** is a severe mental disorder characterized by **psychotic symptoms**, with **delusions** being one of the hallmark positive symptoms.
- These **delusions** often include **persecutory**, **grandiose**, or **somatic themes**, among others.
*Alcohol withdrawal*
- Severe **alcohol withdrawal** can lead to **delirium tremens (DTs)**, which is associated with **psychotic symptoms** such as **delusions** and vivid **hallucinations** (often visual or tactile).
- These **delusions** are often **persecutory** or referential in nature and contribute to the patient's fear and agitation.
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