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35 - Obsessive-compulsive disorder

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Helen Blair Simpson  and
Phil Harrison-Read
Edited by
Peter Tyrer  and
Kenneth R. Silk
Helen Blair Simpson
Affiliation:
New York State Psychiatric Institution New York, NY USA
Phil Harrison-Read
Affiliation:
Department of Psychiatry Royal Free Hospital London UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

You will note from Part I that obsessive-compulsive disorder, formerly called obsessional neurosis before the word neurosis was eliminated from usage, has the highest clinical utility score of the disorders within the neurotic spectrum. It is therefore not surprising that we have much clearer guidelines and evidence for treatment than for others within the spectrum. The arguments in favour of both drug and psychological treatments are strong and are often complementary across the range of clinical indications in OCD. There are some disparities between the UK and USA but most are matters of emphasis rather than fundamental disagreements. We need more evidence from studies on combinations of drug and psychological interventions as this is a very common position in clinical practice.

Introduction

Obsessive-compulsive disorder (OCD) is a relatively common, usually chronic and sometimes very disabling condition, which by convention excludes clinically similar syndromes caused by psychoactive drugs or by a general medical condition. It is characterized by obsessions, compulsions or a combination of both. Obsessions are recurrent and persistent ideas, images or impulses that cause pronounced anxiety and which are usually recognized by the person affected as being self-produced, and yet irrational. Compulsions are intentional repetitive behaviours or mental acts (rituals) performed in response to obsessions or in response to self-imposed rules which are aimed at reducing distress or at preventing unacceptable or anxiety-provoking outcomes. Compulsive rituals are usually recognized as unreasonable, pointless or time-wasting and are also usually resisted by the individual affected.

Type
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Cambridge Textbook of Effective Treatments in Psychiatry , pp. 574 - 587
Publisher: Cambridge University Press
Print publication year: 2008

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  • Obsessive-compulsive disorder
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.037
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  • Obsessive-compulsive disorder
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.037
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  • Obsessive-compulsive disorder
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.037
Available formats
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