Journal Article

Obsessive-compulsive disorder

Roberts, Alison, Veale, David

2014

Overview

[...]OCD is often hidden, as patients believe that their own intrusive thoughts or images are too shameful.What is important in recognising and understanding OCD is not the behaviour but the intended aim of the behaviour.[...]the intended aim of a compulsion in OCD is to verify whether a threat exists (for example, a checking ritual) or to get rid of a threat by \"undoing\" it (for example, by compulsive washing or replacing a thought).[...]the family may seek help for the patient, who may be unwilling to take this step him or herself.For those patients for whom SSRIs and cognitive behavioural therapy have been ineffective, the evidence for adjunctive antipsychotic drugs in the short term is weak and an increased risk of adverse events is seen in the long term.[...]a recent controlled trial of patients resistant to one SSRI found that cognitive behavioural therapy was more effective than either risperidone or a placebo. 31 Meta-analyses show no significant benefit for augmentation with quietapine or olanzapine, a small effect size for risperidone, and a modest effect size for aripiprazole. 32 Antipsychotics are thus recommended only in patients who are refractory to cognitive behavioural therapy and SSRIs.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD
• Subject: Anxiety / Behavior modification / Child development / CLINICAL REVIEW / Cognition & reasoning / Cognitive Therapy / Comorbidity / Fear & phobias / Hoarding disorder / Humans / Neuroses / Obsessive Behavior - diagnosis / Obsessive Behavior - psychology / Obsessive compulsive disorder / Obsessive-Compulsive Disorder - diagnosis / Obsessive-Compulsive Disorder - drug therapy / Obsessive-Compulsive Disorder - psychology / Obsessive-Compulsive Disorder - therapy / Pediatrics / Psychiatry / Quality of life / Serotonin Uptake Inhibitors - therapeutic use / Womens health