Obsessive-compulsive disorder

Author(s):  
Paul M. Salkovskis ◽  
Joan Kirk

Chapter 8 explores obsessive-compulsive disorder (OCD). It first outlines the nature of OCD, its prevalence, the development of current treatments, the behavioural theory of OCD and behaviour therapy in practice, deficit theories and cognitive factors, cognitive behavioural therapy (CBT) for OCD, experimental studies of normal intrusive thoughts, distorted thinking and negative appraisals, treatment implications of the cognitive behavioural theory, and strategies in the treatment of OCD.

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

Obsessive-compulsive disorder (OCD) can be a very disabling and distressing problem. Cognitive behavioural therapy (CBT) has been shown to be very effective in helping people to overcome OCD. OCD is a highly heterogeneous disorder, often complicated by contextual factors, and therapists are often left wondering how to apply their knowledge of treatment to the particular problems as they face them in clinical practice. This book guides the reader through understanding the background to and principles of using CBT for OCD in a clear practical ‘how to’ style. It also elucidates the particular challenges and solutions in applying CBT for OCD using illustrative case material and guidance on formulation-driven intervention. The book also addresses commonly occurring complexities in the treatment of OCD; for example, working with comorbidity, perfectionism, shame, and family involvement in symptoms. Throughout the book, tips are provided on receiving and giving supervision to troubleshoot commonly encountered problems. This book provides a guide to improved practice for clinicians at all levels of experience.


2017 ◽  
Vol 41 (S1) ◽  
pp. S643-S644
Author(s):  
J. Vyskocilova ◽  
J. Prasko ◽  
J. Sipek ◽  
M. Slepecky

BackgroundThe objective of investigation was to determine whether patients with obsessive-compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioural therapy (CBT) lasting six weeks and whether it is possible to predict treatment outcome using clinical and selected psychological characteristics.MethodFrom 66 OCD patients fifty-seven completed program. The diagnosis was confirmed using the structured mini international neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), objective and subjective forms of the Clinical Global Impression (CGI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), dissociative experiences scale, 20-item Somatoform dissociation questionnaire and sheehan disability scale before treatment, and with subjective Y-BOCS, objective and subjective CGI, BAI and BDI at the end of treatment. Patients were treated with antidepressants and daily intensive group CBT for six weeks.ResultsDuring 6-week intensive CBT program in combination with pharmacotherapy, there was significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decreased scores of scales assessing severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who (a) showed fewer OCD themes in symptomatology, (b) showed higher level of somatoform dissociation, (c) had poor insight and (d) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who (a) had good insight, (b) had a lower initial level of anxiety and (c) had no comorbid depressive disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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