Cognitive Therapy with Obsessive–Compulsive Disorder

1995 ◽  
Vol 166 (4) ◽  
pp. 444-450 ◽  
Author(s):  
Ian A. James ◽  
Ivy-Marie Blackburn

BackgroundPeople with obsessive–compulsive disorders (OCD) are widely treated with a combination of medication and behavioural techniques. The success rate is 50–85%, but both relapse and drop-out rates appear high. The use of cognitive therapy (CT) for the treatment of OCD has been suggested. The empirical evidence supporting the use of CT for OCD is examined.MethodA manual and computer (Medline) literature search was performed.ResultsFifteen empirical studies were found: ten non-controlled, and five controlled.ConclusionsThere are few controlled CT studies, and these show little evidence of improvement when CT is added to existing therapeutic techniques.

2000 ◽  
Vol 30 (1) ◽  
pp. 27-39 ◽  
Author(s):  
Helmut Peter ◽  
Susanne Tabrizian ◽  
Iver Hand

Objective: Patients with panic disorder are reported to have elevated cholesterol levels. There is also some evidence that cholesterol elevation is not so much a specific condition in panic disorder but is generally associated with anxiety. So far, there is little data on cholesterol levels in patients with obsessive compulsive disorders (OCD) which is also classified as anxiety disorder. Method: Thirty-three patients with OCD participated in the study. Serum cholesterol was measured as pretreatment and at the end of a ten-week treatment-period. All patients received behavior therapy and, in a double-blind fashion, fluvoxamine or placebo. Severity of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: Pretreatment cholesterol values of OCD patients were compared with cholesterol levels of thirty panic disorder patients and thirty normal controls. OCD patients had elevated cholesterol levels comparable with those of panic disorder patients. Cholesterol levels decreased significantly from pre- to posttreatment. OCD patients with high cholesterol levels (≥ 240 mg/dl, n = 7) could make best use of the treatment whereas patients with desirable cholesterol levels (< 200 mg/dl, n = 11) did not change their cholesterol during treatment. Conclusions: Our data support the assumption that not only panic disorder but also other anxiety disorders, e.g., obsessive compulsive disorders, may be associated with serum cholesterol elevations. Effective treatment (behavior therapy and/or treatment with a selective serotonin reuptake inhibitor [SSRI]) seems to decrease cholesterol levels, especially in patients with pathological cholesterol elevations.


1995 ◽  
Vol 10 (8) ◽  
pp. 386-390 ◽  
Author(s):  
F Arriaga ◽  
E Lara ◽  
A Matos-Pires ◽  
F Cavaglia ◽  
L Bastos

SummaryClinical assessments of sleep and subjective state upon waking were performed in normal controls and patients with generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, primary dysthymia and major depression. Subjects were selected according to DSM-III-R criteria. As compared to normal controls, patients with generalised anxiety, dysthymia and major depression exhibit pervasive and intense complaints of insomnia, and no clear distinctions can be drawn among these groups. Patients with panic disorder do not differ from normal controls, whereas obsessive compulsive patients present limited sleep symptoms. These findings suggest that subjective sleep variables are relevant for the diagnostic discrimination of panic and obsessive-compulsive disorders.


2021 ◽  
Vol 14 (2) ◽  
pp. 282-307
Author(s):  
Derek Botha

This article proposes alternative understandings of certain structuralist informed (Diagnostic and Statistical Manual of Mental Disorders - DSM-IIIrd to 5th Eds.) configurations of mental disorders. Life’s negative discourses and the mind’s captive responses present a “general theory of mental suffering” which phenomena are classified as modernist, DSM mental disorders, such as addictions, depression, and obsessive-compulsive disorders. Recent research has indicated that the psychedelic drug, psilocybin, has produced safe and effective outcomes for these mental suffering states. In this context, the article draws on the concept of brain plasticity order, firstly, to identify the means for a person to move away from subjection of life’s negative, dominant discourses that “capture” the brain, and then to intentionally move towards more acceptable, preferred, ethical subjectivities. These explanations, using the phenomenon of depression, provide the foundation for further proposals that an innovative form of narrative therapy could be a safe, effective and meaningful approach for persons in relationship with other similar ways of mental suffering, such as, anxiety, addiction, obsessive-compulsive disorder, and anorexia nervosa.


Author(s):  
Eric Burguière ◽  
Luc Mallet

Despite the range of conventional treatments available for obsessive–compulsive disorders, generally based on pharmacological and behavioural therapy, a significant number of patients receive no benefit from them. Clearly, further work is required to develop alternative therapeutic approaches to improve the treatment of the dysfunctional cognitive processes in obsessive–compulsive disorders and to better understand the neural networks involved. Some innovative tools have recently been developed in the fields of anatomical and functional imaging, neuromodulation, and animal models. These novel approaches offer opportunities to improve our understanding of the functional and pathophysiological basis of obsessive–compulsive disorders.


2021 ◽  
Vol 4 (4) ◽  
pp. 55-98
Author(s):  
Ali Mahmud Shoeib ◽  
◽  
Ereny Samir Gobrial ◽  

The aims of this study were to identify the correlation between Depersonalization - Derealization Disorder (DPDR), anxiety, depression, and obsessive-compulsive disorders and to propose a constructive model of anxiety, depression and obsessive- compulsive disorders related to Depersonalization Derealization Disorder of university students. The sample consisted of 344 students (325 female and 19 male), with a mean age of (24.4) years. The study applied the following scales: structured clinical interview for depersonalization-derealization spectrum, Cambridge Depersonalization Scale, Generalised anxiety scale (GAD-7), Hamilton Depression Rating Scale and Maudsley Obsessional–Compulsive Inventory. Results indicated that obsessive-compulsive disorder and depression played a major role in developing DPDR due to a significant positive effect of these disorders, while anxiety had a weak correlation. The study developed a constructive model of variables related to DPDR based on AMOS software. The results illustrated that the contribution of obsessive-compulsive and depression as independent variables in predicting PDRD was 61.8 and 44.9, respectively, while no effect of anxiety was recorded. The findings also developed a model for the causal relationships between anxiety, depression, and obsessive-compulsive influence on DPDR disorder. The results of the causal model test indicated that the obsessive-compulsive variable is hypothesized to be a mediator in influencing the DPDR disorder as it is affected by both anxiety and depression.


CNS Spectrums ◽  
1996 ◽  
Vol 1 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Eric Hollander ◽  
Stephanie D. Benzaquen

The obsessive-compulsive disorders spectrum concept has grown in recent years because of the common clinical features, such as obsessive thinking and compulsive rituals, biological markers, presumed etiology, and treatment response, that these disorders may share with obsessive-compulsive disorder (OCD). This concept has important implications in regard to diagnosis, nosology, neurobiology, and treatment of a wide group of diverse disorders affecting up to 10% of the population. New insights in central nervous system (CNS) mechanisms that drive the repetitive behaviors of the obsessive-compulsive spectrum disorders have heightened interest in the spectrum in researchers, clinicians, and those involved in drug development.An important approach in neuropsychiatry centers on employing a dimensional classification of psychopathology. Psychiatric phenomena often fall on a continuum. A dimensional approach allows for the classification of patients who fall at the border of classical entities or who are otherwise atypical. Diagnostic categories are considered along a spectrum if there is considerable overlap in symptoms and in etiology, as demonstrated by familial linkage biological markers, and pharmacological dissection. Categorical and dimensional approaches to the OCD spectrum could have significant implications for diagnosis, nosology, neurobiology, and treatment of a wide group of disorders affecting a sizable percentage of the population.Recent interest has focused on spectrums in movement disorders, affective disorders, schizophrenia, epileptic and impulsive disorders, and obsessive-compulsive disorders (which we will examine here); in addition, there has been interest in the overlap between these spectrums. Viewing disorders in terms of overlapping spectrums provides researchers and clinicians a framework with which to better understand and treat these disorders.


2021 ◽  
Vol 9 (06) ◽  
pp. 61-72
Author(s):  
H. Rharbaoui ◽  
◽  
D. Mzamba ◽  
H. Nafiaa ◽  
M. Kadiri ◽  
...  

Introduction: Obsessive-compulsive disorder is characterized by persistent irrational thoughts manifested by repeated actions. These disorders often have an impact on the social life of those who suffer from them, with a tendency towards isolation which can be exacerbated during this period of confinement. Among these disorders, the fear of contamination is very common. This fear is influenced by culture, society, and global health issues. Thus, in 1920, many cases of fear of syphilis emerged following major awareness campaigns pertaining to the disease. In the 1980s, obsessive disorders related to the risk of HIV infection appeared. Likewise, the Covid-19 coronavirus epidemic is likely to cause a significant deal of anxiety for some people with obsessive-compulsive disorder, thus justifying the aggravation of the clinical condition of this category of patients. The hand-washing recommendations that were promoted during the pandemic would prove to be a major trigger for obsessive-compulsive disorder. Quickly, this gesture becomes an obsession and gradually as the virus spreads, experts expect the cases of associated obsessive-compulsive disorders to increase [1]. Closeness between family members and disrupted habits during confinement can lead to conflict, which can increase the frequency of compulsions. Meditation can also increase the flow of uncontrolled thoughts which can promote the emergence of obsessions. During this time of the pandemic, doctors and people with obsessive-compulsive disorders find themselves in a dilemma. On the one hand, to treat obsessive-compulsive disorders, hand washing is prohibited, and on the other hand, to prevent the spread of the virus, hand washing is strongly recommended. Covid-19 can therefore be an unbearable nightmare, and harder to manage for people with obsessive-compulsive disorders. Objective: This study aims to assess the psychological repercussions of confinement on patients suffering from obsessive-compulsive disorders during the Covid-19 pandemic, and to underline the link between the aggravation of the symptoms of obsessive-compulsive disorder and the underlying perceived stress associated with it. Methodology: This is a descriptive and analytical study, which involves a sample of patients tracked for obsessive-compulsive disorders, and which is founded on collecting their individual information through an anonymous survey, which was submitted via social networks, either by using smartphones or during consultations. As an assessment instrument, in addition to the survey for collecting socio-demographic data, we opted for the Yale-Brown Scale to assess the severity of the symptoms of obsessive-compulsive disorder, as well as the Cohen Perceived Stress Scale (PSS-10) to assess the perceived stress on this group of patients during this pandemic. These scales were chosen because of their frequent use in several studies on the same topic. Results:We collected 102 responses, of which 55% were women 39% of our candidates worked remotely and only 38.8% of patients were able to continue their medical follow-up at the hospital during the confinement. Concerningour results,it was observed that our participants experienced significant changes in terms of the severity of the total symptoms of obsessive-compulsive disorder during the period of confinement with an accentuation of 90% of the symptoms of contamination and 53.8% of the hands washing compulsions during the Covid-19 pandemic. Respondents, who had symptoms of obsessive-compulsive disorder, since the onset of Covid-19, were the only ones who were significantly more likely to be vulnerable to moderately high stress. Likewise, respondents who compulsively washed their hands were significantly more likely to experience vulnerability to moderate to high stress. 45.3% of our applicants were extremely anxious, 33% were very anxious, and 21.7% were anguished to a tolerable level, with a rate of 75.5% of patients developing a social handicap or an inability to function. The sample showed that subjects who could not work or study from a remote position during the quarantine, those who lived with a relative in the same house during the quarantine, and those who showed symptoms of contamination, had significantly greater aggravation of the obsessive-compulsive disorder total symptoms during the confinement. Effects were not significant for other variables including gender, use of online social network sites and applications during the quarantine and remission status on obsessive-compulsive disorder symptoms before quarantine. Conclusion: Our results suggest that the stressful period of the pandemic is associated with a significant worsening of symptoms on patients with obsessive-compulsive disorder, particularly on those with contamination obsessions and washing compulsions. Having obsessive-compulsive disorder would increase the likelihood of experiencing significant stress during this pandemic.


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