Obsessive–Compulsive Disorder

1995 ◽  
Vol 166 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Frank Tallis
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Cognitive Processes ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Central Position ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Us ◽  
Biological Substrates ◽  
The Uk ◽  
Therapy Strategies

Obsessive–compulsive disorder (OCD) has recently undergone a dramatic change in status. Once regarded as a rare example of the neuroses, it now occupies a central position in contemporary psychiatry. The reasons for this renaissance in interest are relatively easy to describe. Firstly, results from the National Institute of Mental Health Epidemiological Catchment Area (ECA) survey indicated that the lifetime prevalence of OCD was 2.5% (1 in 40 people) and the 6-month point prevalence was 1.5%, making it the fourth most common psychiatric disorder in the US (Myers et al, 1984; Robins et al, 1984; Karno et al, 1988). If these figures are applicable to the UK, there may be up to 1 million sufferers. Secondly, the therapeutic efficacy of the selective serotonin reuptake inhibitors (SSRIs) and consistent findings from a number of neuroimaging investigations have stimulated interest in understanding the biological substrates of OCD. Finally, the traditional behavioural account of OCD has been elaborated, with greater emphasis given to cognition and cognitive processes; this revised anatomy of obsessions has, predictably, stimulated the development of specific cognitive therapy strategies.

Role of serotonin in obsessive-compulsive disorder

1998 ◽  
Vol 173 (S35) ◽  
pp. 13-20 ◽  
Author(s):  
H. G. Baumgarten ◽  
Z. Grozdanovic
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Expression Patterns ◽  
Term Treatment ◽  
Continuous Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Long Term Treatment ◽  
Pre Treatment

Background Serotonin may play a role in the pathophysiology of obsessive-compulsive disorder (OCD) because of the anti-obsessional effect of selective serotonin reuptake inhibitors (SSRJs).Method The literature is reviewed on knowledge of the role of serotonergic neurons in brain function, studies on monoamine metabolites in cerebrospinal fluid (CSF), various stress neuropeptides, neuroendocrine and behavioural challenge after administration of direct and indirect serotomimetic compounds, and neuroanatomical data on brain circuits organising behaviour.Results In most of the OCD cases analysed, CSF 5-hydroxyindoleacetic acid and homovanillic acid concentrations do not significantly differ from age-corrected controls. However, a relationship appears to exist between pre-treatment levels of these metabolites and clinical response to drugs acting on the serotonin transporter. Abnormalities in CSF arginine vasopressin, corticotropin-releasing hormone, oxytocin and somatostatin levels have been reported in OCD. Long-term treatment with high-doses of clomipramine, fluvoxamine, and fluoxetine tend to correct these neuropeptide abnormalities.Conclusions We hypothesise that continuous treatment with SSRJs alters serotonin turnover and neuropeptide expression patterns in OCD-entertaining functional forebrain/midbrain circuits.

Cognitive-Behavioral Therapy and Integrated Approaches in the Treatment of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
1999 ◽  
Vol 4 (S3) ◽  
pp. 35-40 ◽  
Author(s):  
Fritz Hohagen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Mental Condition ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

AbstractObsessive-compulsive disorder (OCD) has long been considered a treatment-refractory mental condition. Neither pharmacologic nor psychodynamic therapy has been proven to treat OCD effectively. Yet the prognosis for OCD has changed dramatically in recent years with the introduction of behavior therapy and the use of selective serotonin reuptake inhibitors (SSRIs). Many studies have shown that behavior therapy, especially exposure with response prevention, and SSRIs reduce obsessive-compulsive symptoms significantly. Still, many unanswered questions—including the role of cognitive therapy in the treatment of OCD, exposure therapy vs multimodal behavioral therapy, individual versus group therapy, outcome predictors in adults, adolescents, and children, and the role of combination treatment using an SSRI and cognitive-behavioral therapy—remain. This article will explore these issues as well as suggest directions for further research into OCD.

scholarly journals Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Domenico De Berardis ◽  
Nicola Serroni ◽  
Stefano Marini ◽  
Giovanni Martinotti ◽  
Francesca Ferri ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Chronic Condition ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Atypical Antipsychotics ◽  
Young Female ◽  
Treatment Resistant ◽  
First Line ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Augmentation Strategies

Obsessive-compulsive disorder (OCD) is a chronic condition characterized by obsessions or compulsions that cause distress or interfere with functioning. Selective serotonin reuptake inhibitors are the first-line strategy in the treatment of OCD, but approximately 40% to 60% of patients with OCD fail to respond to them. Several augmentation strategies have been proposed, including the use of atypical antipsychotics and antidepressant combinations. In the present paper we describe the case of a young female patient suffering from severe treatment-resistant OCD who remitted as a result of agomelatine augmentation of escitalopram therapy.

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