When you meet: assessing obsessive-compulsive disorder

Author(s):  
Victoria Bream ◽  
Fiona Challacombe ◽  
Asmita Palmer ◽  
Paul Salkovskis

This chapter provides a practical guide to assessing obsessive-compulsive disorder (OCD) that is both informative to the inexperienced clinician and addresses questions raised by the experienced clinician. It will summarize the diagnostic criteria for OCD, including advice on making a differential diagnosis when presented with symptoms that are associated with other disorders; for example, differentiating OCD from psychosis, generalized anxiety disorder, or health anxiety. It will guide the reader through the process of conducting a thorough assessment of the patient’s presenting problems, including OCD and any comorbid problems. The chapter will offer guidance on how to engage the person with OCD and promote trust. There is clear guidance on risk assessment, differentiating between primary risk factors (which clinicians are typically very good at assessing), and secondary risk factors (which may easily be overlooked). Advice on structuring an assessment and on appropriate assessment tools is provided.

10.2196/11643 ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. e11643 ◽  
Author(s):  
Florian Ferreri ◽  
Alexis Bourla ◽  
Charles-Siegfried Peretti ◽  
Tomoyuki Segawa ◽  
Nemat Jaafari ◽  
...  

Background New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive-compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital phenotype, which involves using computerized measurement tools to capture the characteristics of a given psychiatric disorder, is one paradigmatic example. Objective The impact of new technologies on health professionals’ practice in OCD care remains to be determined. Recent developments could disrupt not just their clinical practices, but also their beliefs, ethics, and representations, even going so far as to question their professional culture. This study aimed to conduct an extensive review of new technologies in OCD. Methods We conducted the review by looking for titles in the PubMed database up to December 2017 that contained the following terms: [Obsessive] AND [Smartphone] OR [phone] OR [Internet] OR [Device] OR [Wearable] OR [Mobile] OR [Machine learning] OR [Artificial] OR [Biofeedback] OR [Neurofeedback] OR [Momentary] OR [Computerized] OR [Heart rate variability] OR [actigraphy] OR [actimetry] OR [digital] OR [virtual reality] OR [Tele] OR [video]. Results We analyzed 364 articles, of which 62 were included. Our review was divided into 3 parts: prediction, assessment (including diagnosis, screening, and monitoring), and intervention. Conclusions The review showed that the place of connected objects, machine learning, and remote monitoring has yet to be defined in OCD. Smartphone assessment apps and the Web Screening Questionnaire demonstrated good sensitivity and adequate specificity for detecting OCD symptoms when compared with a full-length structured clinical interview. The ecological momentary assessment procedure may also represent a worthy addition to the current suite of assessment tools. In the field of intervention, CBT supported by smartphone, internet, or computer may not be more effective than that delivered by a qualified practitioner, but it is easy to use, well accepted by patients, reproducible, and cost-effective. Finally, new technologies are enabling the development of new therapies, including biofeedback and virtual reality, which focus on the learning of coping skills. For them to be used, these tools must be properly explained and tailored to individual physician and patient profiles.


Author(s):  
Rebecca J. Hamblin ◽  
Jennifer Moonjung Park ◽  
Monica S. Wu ◽  
Eric A. Storch

Individuals with obsessive-compulsive disorder (OCD) often have good insight into the irrational nature of their obsessions and the excessive character of their compulsions, but insight exists along a continuum and is markedly poor in some patients. This chapter reviews the assessment and phenomenological correlates of variable insight in OCD in both pediatric and adult populations. It reviews the definition of insight and its relationship to the evolution of diagnostic criteria for obsessive-compulsive disorder, as well as the major assessment tools used to measure and quantify insight for clinical and research purposes. The relationships between insight and clinical characteristics of OCD, including symptom severity, comorbidity, and treatment response are reviewed, followed by a review of neurobiological correlates of insight and the relationship between poor insight and schizophrenia spectrum disorders.


2010 ◽  
Vol 51 (5) ◽  
pp. 480-485 ◽  
Author(s):  
Mehmet Murat Demet ◽  
Artuner Deveci ◽  
E. Oryal Taşkın ◽  
Pınar Erbay Dündar ◽  
Aylin Türel Ermertcan ◽  
...  

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