Advertisement

Obsessive-Compulsive Disorder

  • M. Todd SewellEmail author
  • Nicholas D. Wignall
  • Bradford C. Richards
Chapter

Abstract

Obsessive-compulsive disorder (OCD) is a serious mental illness and frequently leads to psychiatric disability. In addition, individuals struggling with OCD often have other comorbid anxiety-related disorders (Camuri et al., 2014). The treatment of OCD requires experienced mental health professionals with extensive training. There is no empirical evidence that the successful treatment of OCD has ever occurred within integrated health-care settings that typically restrict the number of sessions and session time with patients. One potentially poor outcome of trying to treat OCD within these limitations is that a compromised treatment occurs with marginal symptom reduction that effectively inoculates patients from an empirically supported treatment in the future when relapse occurs. Anecdotally, as a clinician, it is worrisome that this would leave patients discouraged about the treatment and less likely to engage in therapy in the future, especially in more severe presentations in which treatment adherence is less likely to begin with (Mancebo, Pinto, Rasmussen, & Eisen, 2008). One of the primary reasons that briefer treatments of OCD is contraindicated is that OCD is maintained by covert surreptitious safety cognitions that can continue to persist and evolve for years, often requiring years of treatment to extinguish (Jakubovski et al., 2013). It is strongly recommended that integrated health-care settings refer patients with OCD to an experienced mental health professional for treatment.

Keywords

Obsessive compulsive disorder OCD assessment and treatment Treatment options Integrated healthcare 

References

  1. Abramowitz, J. S. (1997). Effectiveness of psychological and pharmacological treatments for obsessive-compulsive disorder: A quantitative review. Journal of Consulting and Clinical Psychology, 65(1), 44–52.  https://doi.org/10.1037/0022-006X.65.1.44 CrossRefPubMedGoogle Scholar
  2. Abramowitz, J. S., Franklin, M. E., Street, G. P., Kozak, M. J., & Foa, E. B. (2000). Effects of comorbid depression on response to treatment for obsessive-compulsive disorder. Behavior Therapy, 31(3), 517–528.  https://doi.org/10.1016/S0005-7894(00)80028-3 CrossRefGoogle Scholar
  3. Ackerman, D., & Greenland, S. (2002). Multivariate meta-analysis of controlled drug studies for obsessive-compulsive disorder. Journal of Clinical Psychopharmacology, 22(3), 309–317.  https://doi.org/10.1097/00004714-200206000-00012 CrossRefPubMedGoogle Scholar
  4. Aldea, M. A., Rahman, O., & Storch, E. A. (2009). The psychometric properties of the Florida Obsessive Compulsive Inventory: Examination in a non-clinical sample. Individual Differences Research, 7(4), 228–238.Google Scholar
  5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.CrossRefGoogle Scholar
  6. Amiaz, R., Fostick, L., Gershon, A., & Zohar, J. (2008). Naltrexone augmentation in OCD: A double-blind placebo-controlled cross-over study. European Neuropsychopharmacology, 18(6), 455–461.  https://doi.org/10.1016/j.euroneuro.2008.01.006 CrossRefPubMedGoogle Scholar
  7. Andersson, E., Enander, J., Andrén, P., Hedman, E., Ljótsson, B., Hursti, T., … Rück, C. (2012). Internet-based cognitive behaviour therapy for obsessive–compulsive disorder: A randomized controlled trial. Psychological Medicine, 42(10), 2193–2203.  https://doi.org/10.1017/S0033291712000244 CrossRefPubMedPubMedCentralGoogle Scholar
  8. Belotto-Silva, C., Diniz, J. B., Malavazzi, D. M., Valério, C., Fossaluza, V., Borcato, S., … Shavitt, R. G. (2012). Group cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: A practical clinical trial. Journal of Anxiety Disorders, 26(1), 25–31.  https://doi.org/10.1016/j.janxdis.2011.08.008 CrossRefPubMedGoogle Scholar
  9. Bergeron, R., Ravindran, A. V., Chaput, Y., Goldner, E., Swinson, R., Van Ameringen, M. A., … Hadrava, V. (2002). Sertraline and fluoxetine treatment of obsessive-compulsive disorder: Results of a double-blind, 6-month treatment study. Journal of Clinical Psychopharmacology, 22(2), 148–154.  https://doi.org/10.1097/00004714-200204000-00007 CrossRefPubMedGoogle Scholar
  10. Bisserbe, J., Lane, R., & Flament, M. (1997). A double-blind comparison of sertraline and clomipramine in outpatients with obsessive-compulsive disorder. European Psychiatry, 12(2), 82–93.  https://doi.org/10.1016/S0924-9338(97)89646-0 CrossRefPubMedGoogle Scholar
  11. Browne, H. A., Gair, S. L., Scharf, J. M., & Grice, D. E. (2014). Genetics of obsessive-compulsive disorder and related disorders. Psychiatric Clinics of North America, 37(3), 319–335.  https://doi.org/10.1016/j.psc.2014.06.002 CrossRefPubMedPubMedCentralGoogle Scholar
  12. Camuri, G., Oldani, L., Dell'Osso, B., Benatti, B., Lietti, L., Palazzo, C., & Altamura, A. C. (2014). Prevalence and disability of comorbid social phobia and obsessive–compulsive disorder in patients with panic disorder and generalized anxiety disorder. International Journal of Psychiatry in Clinical Practice, 18(4), 248–254.  https://doi.org/10.3109/13651501.2014.959972 CrossRefPubMedGoogle Scholar
  13. Crockett, B. A., Churchill, E., & Davidson, J. R. (2004). A double-blind combination study of clonazepam with sertraline in obsessive-compulsive disorder. Annals of Clinical Psychiatry, 16, 127–132.CrossRefPubMedGoogle Scholar
  14. Dollard, J., & Miller, N. E. (1950). Personality and psychotherapy; an analysis in terms of learning, thinking, and culture. New York, NY: McGraw-Hill.Google Scholar
  15. Fineberg, N. A., Hengartner, M. P., Bergbaum, C. E., Gale, T. M., Gamma, A., Ajdacic-Gross, V., … Angst, J. (2013). A prospective population-based cohort study of the prevalence, incidence and impact of obsessive-compulsive symptomatology. International Journal of Psychiatry in Clinical Practice, 17(3), 170–178.  https://doi.org/10.3109/13651501.2012.755206 CrossRefPubMedGoogle Scholar
  16. Fisher, P. L., & Wells, A. (2005). How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behaviour Research and Therapy, 43(12), 1543–1558.  https://doi.org/10.1016/j.brat.2004.11.007 CrossRefPubMedGoogle Scholar
  17. Foa, E. B., Franklin, M. E., & Moser, J. (2002). Context in the clinic: How well do cognitive-behavioral therapies and medications work in combination? Biological Psychiatry, 52(10), 989–997.  https://doi.org/10.1016/S0006-3223(02)01552-4 CrossRefGoogle Scholar
  18. Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The obsessive-compulsive inventory: Development and validation of a short version. Psychological Assessment, 14(4), 485–496.  https://doi.org/10.1037/1040-3590.14.4.485 CrossRefPubMedGoogle Scholar
  19. Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., … Tu, X. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. The American Journal of Psychiatry, 162(1), 151–161.  https://doi.org/10.1176/appi.ajp.162.1.151 CrossRefPubMedGoogle Scholar
  20. Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989a). The Yale-brown obsessive compulsive scale: II. Validity. Archives of General Psychiatry, 46(11), 1012–1016.  https://doi.org/10.1001/archpsyc.1989.01810110054008 CrossRefPubMedGoogle Scholar
  21. Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., … Charney, D. S. (1989b). The Yale-brown obsessive compulsive scale: I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011.  https://doi.org/10.1001/archpsyc.1989.01810110048007 CrossRefPubMedGoogle Scholar
  22. Hansen, E. S., Hasselbalch, S., Law, I., & Bolwig, T. G. (2002). The caudate nucleus in obsessive—Compulsive disorder. Reduced metabolism following treatment with paroxetine: A PET study. The International Journal of Neuropsychopharmacology, 5(1), 1–10.  https://doi.org/10.1017/S1461145701002681 CrossRefPubMedGoogle Scholar
  23. Hazlett-Stevens, H. (2009). Assessment and treatment of anxiety in primary care. In L. C. James, W. T. O.'. Donohue, & L. C. James (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 169–182). New York, NY: Springer.Google Scholar
  24. Hewlett, W. A., Vinogradov, S., & Agras, W. S. (1992). Clomipramine, clonazepam, and clonidine treatment of obsessive-compulsive disorder. Journal of Clinical Psychopharmacology, 12(6), 420–430.  https://doi.org/10.1097/00004714-199212000-00008 CrossRefPubMedGoogle Scholar
  25. Hoehn-Saric, R., Ninan, P., Black, D. W., Stahl, S., Greist, J. H., Lydiard, B., … Harrison, W. (2000). Multicenter double-blind comparison of sertraline and desipramine for concurrent obsessive-compulsive and major depressive disorders. Archives of General Psychiatry, 57(1), 76–82.  https://doi.org/10.1001/archpsyc.57.1.76 CrossRefPubMedGoogle Scholar
  26. Hollander, E., Allen, A., Steiner, M., Wheadon, D. E., Oakes, R., & Burnham, D. B. (2003). Acute and long-term treatment and prevention of relapse of obsessive-compulsive disorder with paroxetine. The Journal of Clinical Psychiatry, 64(9), 1113–1121.  https://doi.org/10.4088/JCP.v64n0919 CrossRefPubMedGoogle Scholar
  27. Hollander, E., Kaplan, A., & Stahl, S. M. (2003). A double-blind, placebo-controlled trial of clonazepam in obsessive-compulsive disorder. World Journal of Biological Psychiatry, 4, 30–34.CrossRefPubMedGoogle Scholar
  28. Jakubovski, E., Diniz, J. B., Valerio, C., Fossaluza, V., Belotto-Silva, C., Gorenstein, C., … Shavitt, R. G. (2013). Clinical predictors of long-term outcome in obsessive-compulsive disorder. Depression and Anxiety, 30(8), 763–772.  https://doi.org/10.1002/da.22013 CrossRefPubMedGoogle Scholar
  29. Jenike, M. A., Baer, L., & Buttolph, L. (1991). Buspirone augmentation of fluoxetine in patients with obsessive compulsive disorder. The Journal of Clinical Psychiatry, 52(1), 13–14.PubMedGoogle Scholar
  30. Jónsson, H., Hougaard, E., & Bennedsen, B. E. (2011). Randomized comparative study of group versus individual cognitive behavioural therapy for obsessive compulsive disorder. Acta Psychiatrica Scandinavica, 123(5), 387–397.  https://doi.org/10.1111/j.1600-0447.2010.01613.x CrossRefPubMedGoogle Scholar
  31. Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, 14(Suppl 1), S1.  https://doi.org/10.1186/1471-244X-14-S1-S1 CrossRefPubMedPubMedCentralGoogle Scholar
  32. Kennedy, B. L., & Schwab, J. J. (1997). Utilization of medical specialists by anxiety disorder patients. Psychosomatics: Journal of Consultation And Liaison Psychiatry, 38(2), 109–112.  https://doi.org/10.1016/S0033-3182(97)71478-6 CrossRefGoogle Scholar
  33. Krochmalik, A., Jones, M. K., Menzies, R. G., & Kirkby, K. (2004). The superiority of danger ideation reduction therapy (DIRT) over exposure and response prevention (ERP) in treating compulsive washing. Behaviour Change, 21(4), 251–268.  https://doi.org/10.1375/bech.21.4.251.66103 CrossRefGoogle Scholar
  34. Kuiper, E. A., Batelaan, N. M., van Oppen, P., Hendriks, G., & van Balkom, A. J. (2013). Gastro-intestinal conditions in patients with obsessive compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 2(4), 437–438.  https://doi.org/10.1016/j.jocrd.2013.10.004 CrossRefGoogle Scholar
  35. Lakerveld, J., Bot, S. D., Chinapaw, M. J., van Tulder, M. W., Kostense, P. J., Dekker, J. M., & Nijpels, G. (2013). Motivational interviewing and problem solving treatment to reduce type 2 diabetes and cardiovascular disease risk in real life: A randomized controlled trial. The International Journal of Behavioral Nutrition and Physical Activity, 10.Google Scholar
  36. Lewis R. Baxter, (1992). Caudate Glucose Metabolic Rate Changes With Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder. Archives of General Psychiatry, 49(9), 681  https://doi:10.1001/archpsyc.1992.01820090009002
  37. Lovell, K., Cox, D., Haddock, G., Jones, C., Raines, D., Garvey, R., … Hadley, S. (2006). Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: Randomised controlled non-inferiority trial. BMJ: British Medical Journal, 333(7574), 883.  https://doi.org/10.1136/bmj.38940.355602.80 CrossRefPubMedPubMedCentralGoogle Scholar
  38. Mancebo M.C., Pinto A., Rasmussen S.A., Eisen J.L. (2008) Development of the treatment adherence survey–Patient version (TAS-P) for OCD. Journal of Anxiety Disorders. 22(1), 32–43. DOI:  10.1016/j.janxdis.2007.01.009
  39. McConnaughy, E. A., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research & Practice, 20(3), 368–375.  https://doi.org/10.1037/h0090198 CrossRefGoogle Scholar
  40. McDougle, C. J., Price, L. H., Goodman, W. K., Charney, D. S., & Heninger, G. R. (1991). A controlled trial of lithium augmentation in fluvoxamine-refractory obsessive-compulsive disorder: Lack of efficacy. Journal of Clinical Psychopharmacology, 11(3), 175–184.  https://doi.org/10.1097/00004714-199106000-00005 CrossRefPubMedGoogle Scholar
  41. McKay, D., Sookman, D., Neziroglu, F., Wilhelm, S., Stein, D. J., Kyrios, M., … Veale, D. (2015). Efficacy of cognitive-behavioral therapy for obsessive–compulsive disorder. Psychiatry Research, 227(1), 104–113.  https://doi.org/10.1016/j.psychres.2015.02.004 CrossRefPubMedGoogle Scholar
  42. Moritz, S., & Jelinek, L. (2011). Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts. Depression and Anxiety, 28(7), 574–581.  https://doi.org/10.1002/da.20843 CrossRefPubMedGoogle Scholar
  43. Moritz, S., Jelinek, L., Hauschildt, M., & Naber, D. (2010). How to treat the untreated: Effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 12(2), 209–220.PubMedPubMedCentralGoogle Scholar
  44. Nakao, T., Okada, K., & Kanba, S. (2014). Neurobiological model of obsessive–compulsive disorder: Evidence from recent neuropsychological and neuroimaging findings. Psychiatry and Clinical Neurosciences, 68(8), 587–605.  https://doi.org/10.1111/pcn.12195 CrossRefPubMedGoogle Scholar
  45. Ninan, P. T., Koran, L. M., Kiev, A., Davidson, J. T., Rasmussen, S. A., Zajecka, J. M., … Austin, C. (2006). High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: A multicenter double-blind trial. The Journal of Clinical Psychiatry, 67(1), 15–22.  https://doi.org/10.4088/JCP.v67n0103 CrossRefPubMedGoogle Scholar
  46. O’Connor, K. P., Aardema, F., Bouthillier, D., Fournier, S., Guay, S., Robillard, S., … Pitre, D. (2005). Evaluation of an inference-based approach to treating obsessive-compulsive disorder. Cognitive Behaviour Therapy, 34(3), 148–163.  https://doi.org/10.1080/16506070510041211 CrossRefPubMedGoogle Scholar
  47. Ong, C. W., Clyde, J. W., Bluett, E. J., Levin, M. E., & Twohig, M. P. (2016). Dropout rates in exposure with response prevention for obsessive-compulsive disorder: What do the data really say? Journal of Anxiety Disorders, 40, 8–17.  https://doi.org/10.1016/j.janxdis.2016.03.006 CrossRefPubMedGoogle Scholar
  48. Öst, L., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review, 40, 156–169.  https://doi.org/10.1016/j.cpr.2015.06.003 CrossRefPubMedGoogle Scholar
  49. Ougrin, D. (2011). Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis. BMC Psychiatry, 11.Google Scholar
  50. Ponniah, K., Iliana, M., & Hollon, S. D. (2013). An update on the efficacy of psychological therapies in the treatment of obsessive-compulsive disorder in adults. Journal of Obsessive-Compulsive and Related Disorders, 2(2), 207–218.Google Scholar
  51. Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory Research and Practice, 19, 276–288.CrossRefGoogle Scholar
  52. Rosa-Alcázar, A. I., Sánchez-Meca, J., Gómez-Conesa, A., & Marín-Martínez, F. (2008). Psychological treatment of obsessive-compulsive disorder: A meta-analysis. Clinical Psychology Review, 28(8), 1310–1325.  https://doi.org/10.1016/j.cpr.2008.07.001 CrossRefPubMedGoogle Scholar
  53. Roshanaei-Moghaddam, B., Pauly, M. C., Atkins, D. C., Baldwin, S. A., Stein, M. B., & Roy-Byrne, P. (2011). Relative effects of CBT and pharmacotherapy in depression versus anxiety: Is medication somewhat better for depression, and CBT somewhat better for anxiety? Depression and Anxiety, 28(7), 560–567.  https://doi.org/10.1002/da.20829 CrossRefPubMedGoogle Scholar
  54. Simpson, H. B., Liebowitz, M. R., Foa, E. B., Kozak, M. J., Schmidt, A. B., Rowan, V., … Campeas, R. (2004). Post-treatment effects of exposure therapy and clomipramine in obsessive-compulsive disorder. Depression and Anxiety, 19(4), 225–233.  https://doi.org/10.1002/da.20003 CrossRefPubMedGoogle Scholar
  55. Storch, E. A., Bagner, D., Merlo, L. J., Shapira, N. A., Geffken, G. R., Murphy, T. K., & Goodman, W. K. (2007). Florida obsessive-compulsive inventory: Development, reliability, and validity. Journal of Clinical Psychology, 63(9), 851–859.  https://doi.org/10.1002/jclp.20382 CrossRefPubMedGoogle Scholar
  56. Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705–716.  https://doi.org/10.1037/a0020508 CrossRefPubMedPubMedCentralGoogle Scholar
  57. van der Heiden, C., van Rossen, K., Dekker, A., Damstra, M., & Deen, M. (2016). Metacognitive therapy for obsessive–compulsive disorder: A pilot study. Journal of Obsessive-Compulsive and Related Disorders, 9, 24–29.  https://doi.org/10.1016/j.jocrd.2016.02.002 CrossRefGoogle Scholar
  58. van Oppen, P., van Balkom, A. J., de Haan, E., & van Dyck, R. (2005). Cognitive therapy and exposure in vivo alone and in combination with fluvoxamine in obsessive-compulsive disorder: A 5-year follow-up. Journal of Clinical Psychiatry, 66, 1415–1422.CrossRefPubMedGoogle Scholar
  59. Veldhuis, J., Dieleman, J. P., Wohlfarth, T., Storosum, J. G., van Den Brink, W., Sturkenboom, M. M., & Denys, D. (2012). Incidence and prevalence of 'diagnosed OCD' in a primary care, treatment seeking, population. International Journal of Psychiatry in Clinical Practice, 16(2), 85–92.  https://doi.org/10.3109/13651501.2011.617454 CrossRefPubMedGoogle Scholar
  60. Vulink, N. C., Denys, D., & Westenberg, H. M. (2005). Bupropion for patients with obsessive-compulsive disorder: An open-label, fixed-dose study. The Journal of Clinical Psychiatry, 66(2), 228–230.  https://doi.org/10.4088/JCP.v66n0211 CrossRefPubMedGoogle Scholar
  61. Whittal, M. L., Robichaud, M., Thordarson, D. S., & McLean, P. D. (2008). Group and individual treatment of obsessive-compulsive disorder using cognitive therapy and exposure plus response prevention: A 2-year follow-up of two randomized trials. Journal of Consulting and Clinical Psychology, 76(6), 1003–1014.  https://doi.org/10.1037/a0013076 CrossRefPubMedGoogle Scholar
  62. Wilhelm, S., Steketee, G., Fama, J. M., Buhlmann, U., Teachman, B. A., & Golan, E. (2009). Modular cognitive therapy for obsessive-compulsive disorder: A wait-list controlled trial. Journal of Cognitive Psychotherapy, 23(4), 294–305.  https://doi.org/10.1891/0889-8391.23.4.294 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • M. Todd Sewell
    • 1
    Email author
  • Nicholas D. Wignall
    • 1
  • Bradford C. Richards
    • 1
  1. 1.Cognitive Behavioral Institute of AlbuquerqueAlbuquerqueUSA

Personalised recommendations