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Obsessive-compulsive Disorder (obsessive-compulsive + disorder)
Kinds of Obsessive-compulsive Disorder Selected AbstractsPractitioner Review: Treatment of Obsessive-Compulsive Disorder in Children and AdolescentsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2000Judith L. Rapoport This paper reviews the treatment of obsessive-compulsive disorder (OCD) in children and adolescents. Focusing on clinical features of the disorder and its treatment particular to pediatric onset, diagnosis, assessment, and behavioral, pharmacological, as well as new investigative treatments are covered. Adaptation of cognitive-behavioral therapy for children and adolescents, use of augmenting agents in drug treatment, and subtyping of OCD cases are developments relevant for current practice. [source] Obsessive-Compulsive Disorder in Children and AdolescentsCHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2001Roz Shafran Obsessive-compulsive disorder (OCD) is estimated to affect between 0.5% and 2% of children and adolescents. The majority of clinical cases has both obsessions and compulsions. Depression, anxiety and tic disorders are common comorbid diagnoses, and assessment can therefore be complex. Several theories have been proposed for the aetiology and maintenance of the disorder, including cognitive-behavioural and neuropsychiatric theories. Cognitive-behavioural and pharmacological treatments are both probably efficacious therapies for children and adolescents but further research is needed to compare these treatments with each other, and to examine the use of combination therapies in controlled trials. [source] Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the national survey of American life,DEPRESSION AND ANXIETY, Issue 12 2008Joseph A. Himle Ph.D. Abstract Background: There is limited research regarding the nature and prevalence of obsessive-compulsive disorder (OCD) among various racial and ethnic subpopulations within the United States, including African Americans and blacks of Caribbean descent. Although heterogeneity within the black population in the United States has largely been ignored, notable differences exist between blacks of Caribbean descent and African Americans with respect to ethnicity, national heritage, and living circumstances. This is the first comprehensive examination of OCD among African Americans and blacks of Caribbean descent. Methods: Data from the National Survey of American Life, a national household probability sample of African Americans and Caribbean blacks in the United States, were used to examine rates of OCD among these groups. Results: Lifetime and 12-month OCD prevalence estimates were very similar for African Americans and Caribbean blacks. Persistence of OCD and rates of co-occurring psychiatric disorders were very high and also similar between African American and Caribbean black respondents. Both groups had high levels of overall mental illness severity and functional impairment. Use of services was low for both groups, particularly in specialty mental health settings. Use of anti-obsessional medications was also rare, especially among the Caribbean black OCD population. Conclusions: OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment. It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups. Depression and Anxiety, 2008. Published 2008 Wiley-Liss, Inc. [source] Obsessive-compulsive disorder following left middle cerebral artery infarctACTA NEUROPSYCHIATRICA, Issue 1 2007Laurence Borras No abstract is available for this article. [source] Obsessive-Compulsive Disorder in Children and AdolescentsCHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2001Roz Shafran Obsessive-compulsive disorder (OCD) is estimated to affect between 0.5% and 2% of children and adolescents. The majority of clinical cases has both obsessions and compulsions. Depression, anxiety and tic disorders are common comorbid diagnoses, and assessment can therefore be complex. Several theories have been proposed for the aetiology and maintenance of the disorder, including cognitive-behavioural and neuropsychiatric theories. Cognitive-behavioural and pharmacological treatments are both probably efficacious therapies for children and adolescents but further research is needed to compare these treatments with each other, and to examine the use of combination therapies in controlled trials. [source] Successful medication withdrawal after cognitive-behavioral therapy in a treatment-resistant preadolescent male with obsessive-compulsive disorderDEPRESSION AND ANXIETY, Issue 1 2009Robert B. Goldstein M.D. Abstract There are no reports of a child taking a selective serotonin reuptake inhibitor and an atypical anti-psychotic being successfully tapered from these medications after completion of cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder. With this in mind, we report the case of an 8.5-year,old male who was taking risperidone 0.5,mg bid, sertraline 100,mg, and atomoxetine 25,mg at presentation. After a successful course of CBT, we describe how medications were systematically withdrawn. Implications of this case on practice parameters (e.g., CBT may be an effective augmenting agent for those non-responsive to initial pharmacological treatments) are highlighted. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source] Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the national survey of American life,DEPRESSION AND ANXIETY, Issue 12 2008Joseph A. Himle Ph.D. Abstract Background: There is limited research regarding the nature and prevalence of obsessive-compulsive disorder (OCD) among various racial and ethnic subpopulations within the United States, including African Americans and blacks of Caribbean descent. Although heterogeneity within the black population in the United States has largely been ignored, notable differences exist between blacks of Caribbean descent and African Americans with respect to ethnicity, national heritage, and living circumstances. This is the first comprehensive examination of OCD among African Americans and blacks of Caribbean descent. Methods: Data from the National Survey of American Life, a national household probability sample of African Americans and Caribbean blacks in the United States, were used to examine rates of OCD among these groups. Results: Lifetime and 12-month OCD prevalence estimates were very similar for African Americans and Caribbean blacks. Persistence of OCD and rates of co-occurring psychiatric disorders were very high and also similar between African American and Caribbean black respondents. Both groups had high levels of overall mental illness severity and functional impairment. Use of services was low for both groups, particularly in specialty mental health settings. Use of anti-obsessional medications was also rare, especially among the Caribbean black OCD population. Conclusions: OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment. It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups. Depression and Anxiety, 2008. Published 2008 Wiley-Liss, Inc. [source] Anxiety disorders and risk for suicide attempts: findings from the Baltimore Epidemiologic Catchment area follow-up study,DEPRESSION AND ANXIETY, Issue 6 2008James M. Bolton M.D. Abstract Our objective was to determine whether the presence of an anxiety disorder was a risk factor for future suicide attempts. Data were drawn from the 13-year follow-up Baltimore Epidemiological Catchment Area survey (n=1,920). Multiple logistic regression analysis was used to determine the association between baseline anxiety disorders (social phobia, simple phobia, obsessive-compulsive disorder, panic attacks, or agoraphobia) and subsequent onset suicide attempts. The presence of one or more anxiety disorders at baseline was significantly associated with subsequent onset suicide attempts (adjusted odds ratio 2.20, 95% confidence interval 1.04,4.64) after controlling for sociodemographic variables and all baseline mental disorders assessed in the survey. These findings suggest that anxiety disorders are independent risk factors for suicide attempts, and underscore the importance of anxiety disorders as a serious public health problem. Depression and Anxiety 0:1,5, 2007. Published 2007 Wiley-Liss. [source] Anger experience and expression across the anxiety disordersDEPRESSION AND ANXIETY, Issue 2 2008David A. Moscovitch Ph.D. Abstract The purpose of this study was to explore possible differences in the experience and expression of anger across four anxiety disorder groups and non-clinical controls. Anger was assessed by two measures, the Reaction Inventory and the Aggression Questionnaire, in 112 individuals who met DSM-IV criteria for panic disorder (PD) with or without agoraphobia (n=40), obsessive-compulsive disorder (OCD; n=30), social phobia, (SOC; n=28), and specific phobia (SPC; n=14) as well as non-clinical controls (n=49). Patients with PD, OCD, and SOC reported a significantly greater propensity to experience anger than controls, whereas patients with SPC exhibited no differences in anger experience in comparison to controls. In addition, patients with PD reported significantly greater levels of anger aggression compared to both controls and patients with OCD, and patients with SOC reported significantly lower levels of verbal aggression than controls. Most, but not all, of these differences disappeared when symptoms of depression were controlled in the analyses. The implications of these findings and future directions for research are discussed 0:1,7, 2007. © 2007 Wiley-Liss, Inc. [source] Childhood trauma in obsessive-compulsive disorder, trichotillomania, and controlsDEPRESSION AND ANXIETY, Issue 2 2002Christine Lochner M.A. Abstract There is relatively little data on the link between childhood trauma and obsessive-compulsive/putative obsessive-compulsive spectrum disorders. The revised Childhood Trauma Questionnaire (CTQ), which assesses physical, emotional, and sexual abuse as well as physical and emotional neglect, was administered to female patients with obsessive-compulsive disorder (OCD; n = 74; age: 36.1 ± 16.3), TTM (n = 36; age: 31.8 ± 12.3), and a group of normal controls (n = 31; age: 21.5 ± 1.0). The findings showed a significantly greater severity of childhood trauma in general, and emotional neglect specifically, in the patient groups compared to the controls. Although various factors may play a role in the etiology of both OCD and trichotillomania (TTM), this study is consistent with some evidence from previous studies suggesting that childhood trauma may play a role in the development of these disorders. Depression and Anxiety 15:66,68, 2002. © 2002 Wiley-Liss, Inc. [source] The zebrafish bHLH PAS transcriptional regulator, single-minded 1 (sim1), is required for isotocin cell developmentDEVELOPMENTAL DYNAMICS, Issue 8 2006Jennifer L. Eaton Abstract A wide range of physiological and behavioral processes, such as social, sexual, and maternal behaviors, learning and memory, and osmotic homeostasis are influenced by the neurohypophysial peptides oxytocin and vasopressin. Disruptions of these hormone systems have been linked to several neurobehavioral disorders, including autism, Prader-Willi syndrome, affective disorders, and obsessive-compulsive disorder. Studies in zebrafish promise to reveal the complex network of regulatory genes and signaling pathways that direct the development of oxytocin- and vasopressin-like neurons, and provide insight into factors involved in brain disorders associated with disruption of these systems. Isotocin, which is homologous to oxytocin, is expressed early, in a simple pattern in the developing zebrafish brain. Single-minded 1 (sim1), a member of the bHLH-PAS family of transcriptional regulatory genes, is required for terminal differentiation of mammalian oxytocin cells and is a master regulator of neurogenesis in Drosophila. Here we show that sim1 is expressed in the zebrafish forebrain and is required for isotocin cell development. The expression pattern of sim1 mRNA in the embryonic forebrain is dynamic and complex, and overlaps with isotocin expression in the preoptic area. We provide evidence that the role of sim1 in zebrafish neuroendocrine cell development is evolutionarily conserved with that of mammals. Developmental Dynamics 235:2071,2082, 2006. © 2006 Wiley-Liss, Inc. [source] Recollections of parent,child relationships in patients with obsessive-compulsive disorder and panic disorder with agoraphobiaACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2002L. Turgeon Objective:,In previous studies, patients with different psychiatric conditions, as compared with matched controls, have reported that their parents were more protective and less caring towards them when they were children. However, studies investigating associations between parental behaviours and anxiety disorders have yielded inconsistent results. The aim of this study was to compare recalled parental behaviours in out-patients with obsessive-compulsive disorder (OCD), in out-patients with panic disorder with agoraphobia (PDA), and in non-anxious controls. Method:,The sample included 43 out-patients with OCD, 38 with PDA, and 120 controls. Participants completed the Parental Bonding Instrument and the Egna Minnen Beträffande Uppfostran or Own Memories of Parental Rearing Experiences in Childhood. Results:,No differences were found between the two anxious groups. However, compared with the control group, anxious patients recalled their parents as more protective. Conclusion:,Our findings suggest that child rearing practices such as overprotection may be a risk factor in the development of anxiety disorders. [source] On the role of cortical glutamate inobsessive-compulsive disorder and attention-deficit hyperactivity disorder, two phenomenologically antithetical conditionsACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2000Maria L. CarlssonArticle first published online: 24 DEC 200 Objective: The objective of the present study was to compare the phenomenology and pathophysiology of obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder/deficits in attention, motor control and perception (ADHD/DAMP). Method: Through detailed studies of the literature on OCD and ADHD/DAMP the phenomenology of these two conditions is compared, and possible underlying pathophysiological mechanisms involving interactions between glutamate, dopamine, serotonin and acetylcholine are discussed, with emphasis on OCD. The present paper also discusses possible mechanisms of action for current pharmacological treatments of OCD and ADHD, as well as possible future treatment strategies for these disorders. Results: OCD and ADHD/DAMP are common neuropsychiatric conditions which in many regards appear to be each other's antipodes with respect to clinical manifestations, associated personality traits and brain biochemistry, notably prefrontal cortical glutamate activity. Future pharmacological treatments of these disorders may involve manipulations with glutamate, dopamine D1, serotonin 2A and nicotine receptors. Conclusion: It appears that OCD is a hyperglutamatergic and ADHD a hypoglutamatergic condition, with prefrontal brain regions being especially affected. [source] Dissociation between MEG alpha modulation and performance accuracy on visual working memory task in obsessive compulsive disorderHUMAN BRAIN MAPPING, Issue 12 2007Kristina T. Ciesielski Abstract Oscillatory brain activity in the alpha band (8,13 Hz) is modulated by cognitive events. Such modulation is reflected in a decrease of alpha (event-related desynchronization; ERD) with high cognitive load, or an increase (event-related synchronization) with low cognitive demand or with active inhibition of distractors. We used magnetoencephalography to investigate the pattern of prefrontal and parieto-occipital alpha modulation related to two variants of visual working memory task (delayed matching-to-sample) with and without a distractor. We tested nonmedicated, nondepressed patients suffering obsessive-compulsive disorder (OCD), and pair-matched healthy controls. The level of event-related alpha as a function of time was estimated using the temporal-spectral evolution technique. The results in OCD patients indicated: (1) a lower level of prestimulus (reference) alpha when compared to controls, (2) a task-phase specific reduction in event-related alpha ERD in particular for delayed matching-to-sample task with distractor, (3) no significant correlations between the pattern of modulation in prefrontal and parietal-occipital alpha oscillatory activity. Despite showing an abnormally low alpha modulation, the OCD patients' performance accuracy was normal. The results suggest a relationship of alpha oscillations and the underlying thalamocortical network to etiology of OCD and an involvement of a compensatory mechanism related to effortful inhibition of extrinsic and intrinsic interference. Hum Brain Mapp 2007. © 2007 Wiley-Liss, Inc. [source] Factors associated with treatment nonadherence among US bipolar disorder patients,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 2 2008Ross J. Baldessarini Abstract Objective Since sustained treatment-adherence is often problematic and may limit clinical outcomes among bipolar disorder (BPD) patients, we sought risk factors to guide clinical prediction of nonadherence. Methods Data were from a 2005 US national sample providing questionnaire responses by 131 randomly selected prescribing psychiatrists and their adult BPD patients. We contrasted demographic and clinical factors in treatment-adherent versus nonadherent patients (strictly defined as missing ,1 dose within 10 days) in univariate analyses followed by multivariate logistic-regression modeling. Results Of 429 DSM-IV BPD patients (79% type-I; 62% women; 17% minorities), 34% reported missing,,,1 dose of psychotropic medication within 10 days, 20% missed entire daily doses at least once, and only 2.5% missed all doses for 10 days. However, their prescribing psychiatrists considered only 6% as treatment-nonadherent. Factors significantly associated with nonadherence in multivariate modeling ranked: alcohol-dependence,>,youth,>,greater affective morbidity,>,various side effects,,,comorbid obsessive-compulsive disorder,,,recovering from mania-hypomania. Unrelated were sex, diagnostic subtype, and other comorbidities. Since most patients received,,,2 psychotropics, potential relationships between treatment-complexity and adherence were obscured. Conclusions Prevalent treatment-nonadherence among American BPD patients, and striking underestimation of the problem by prescribing clinicians may encourage increasingly complex treatment-regimens of untested value, but added expense, risk of adverse effects, and uncertain impact on treatment-adherence itself. Copyright © 2007 John Wiley & Sons, Ltd. [source] A review of the possible relevance of inositol and the phosphatidylinositol second messenger system (PI-cycle) to psychiatric disorders,focus on magnetic resonance spectroscopy (MRS) studiesHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2005Hyeonjin Kim Abstract Myo -inositol is an important part of the phosphatidylinositol second messenger system (PI-cycle). Abnormalities in nerve cell myo -inositol levels and/or PI-cycle regulation has been suggested as being involved in the pathophysiology and/or treatment of many psychiatric disorders including bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, eating disorders and schizophrenia. This review examines the metabolism and biochemical importance of myo -inositol and the PI-cycle. It relates this to the current in vivo evidence for myo -inositol and PI-cycle involvement in these psychiatric disorders, particularly focusing upon the magnetic resonance spectroscopy (MRS) findings in patient studies to date. From this review it is concluded that while the evidence suggests probable relevance to the pathophysiology and/or treatment of bipolar disorder, there is much less support for a significant role for the PI-cycle or myo -inositol in any other psychiatric disorder. More definitive investigation is required before PI-cycle dysfunction can be considered specific to bipolar disorder. Copyright © 2005 John Wiley & Sons, Ltd. [source] Fluvoxamine in obsessive-compulsive disorder: similar efficacy but superior tolerability in comparison with clomipramineHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2001Emanuela Mundo Abstract Some meta-analyses have suggested that the selective serotonin reuptake inhibitors (SSRIs) are less effective than clomipramine in the treatment of obsessive-compulsive disorder (OCD). The aim of this double-blind, randomised, multicentre study was to directly compare the efficacy and safety of fluvoxamine and clomipramine in patients with OCD. A total of 227 patients were randomised to flexible doses of fluvoxamine or clomipramine (both 150,300,mg/day) for 10 weeks. Fluvoxamine and clomipramine were both clinically effective and there were no statistically significant differences between the two treatment groups, at any visit, on the National Institute of Mental Health Obsessive-Compulsive global rating scale, the Yale-Brown Obsessive-Compulsive scale (total score and obsession and compulsion subscores), the Clinical Global Impression severity of illness and global improvement subscales, the Clinical Anxiety Scale and the 17-item Hamilton Depression Rating Scale. However, there were differences in safety between the two treatments. Compared with fluvoxamine-treated patients, those treated with clomipramine had more anticholinergic side effects (dry mouth, constipation and tremor) and premature withdrawals due to adverse events (18 versus 9). The results from this controlled study indicate that fluvoxamine is as effective as clomipramine in the treatment of OCD but has a better tolerability profile. Copyright © 2001 John Wiley & Sons, Ltd. [source] PANDAS anorexia nervosa,Endangered, extinct or nonexistent?INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2008Frances Puxley BSc Abstract Objective: Substantial evidence exists for the concept of pediatric autoimmune neuropsychiatric disorders associated with streptoccoccal infection (PANDAS) such as some cases of obsessive-compulsive disorder and tics/Tourette's syndrome. More recently PANDAS-AN has been described. The aim of this article is to provide a critical review of this concept. Method: The literature was searched using Medline, Psychinfo, and Google. Results: There is some evidence for the entity of PANDAS-AN but this is considerably limited by a wide range of methodological problems, including the seemingly low prevalence, the lack of clarity in diagnostic criteria, and the lack of specificity in the diagnostic tests. Innovative treatment approaches hold promise but require further evaluation. Conclusion: Further research into PANDAS-AN, using more clearly defined and consistent diagnostic criteria is needed, given the potential for enhancing the understanding of the pathogenesis of AN and for more effective treatments. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Anorexia nervosa and obsessive-compulsive disorder in a prepubertal patient with bone dysplasia: A case reportINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2005Luisa Lázaro MD Abstract Objective The current article describes the case of a 13-year-old girl with body dysplasia, anorexia nervosa, and obsessive-compulsive disorder (OCD). Method She was given cognitive-behavioral therapy and pharmacologic treatment for the obsessive-compulsive symptomatology and exogenous growth hormone to increase her height. Results She experienced an adequate weight and height increase and remission of obsessive-compulsive symptomatology, and reestablished adequate social and academic functioning. Conclusion After a follow-up of almost 2 years, she had had her menarche, continued her positive eating habits, and had not relapsed into OCD. © 2005 by Wiley Periodicals, Inc. [source] Brief scheduled phone support from a clinician to enhance computer-aided self-help for obsessive-compulsive disorder: Randomized controlled trialJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2005Mark Kenwright Treatment-resistant obsessive-compulsive disorder (OCD) patients from around the United Kingdom who employed computer-guided self-help by using BTSteps over 17 weeks were randomized to have brief live phone support from a clinician either (1) in nine Scheduled clinician-initiated calls or (2) only in calls Requested by the patient (n = 22 per condition). Call content and mean duration were similar across conditions. Scheduled -support patients dropped out significantly less often, did more homework of self-exposure and self-imposed ritual prevention (95% vs. 57%), and showed more improvement in OCD symptoms and disability. Mean total support time per patient over 17 weeks was 76 minutes for Scheduled and 16 minutes for Requested patients. Giving brief support proactively by phone enhanced OCD patients' completion of and improvement with computer-aided self-help. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 1499,1508, 2005. [source] Thought disorder in patients with obsessive-compulsive disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2005Han-Joo Lee We examined the presence of disordered thinking/perception in patients with obsessive-compulsive disorder (OCD). Recently, an obsession model has been proposed, which classifies obsessions into two different subtypes: autogenous obsessions and reactive obsessions (Lee & Kwon, 2003). Based on this model, we hypothesized that OCD patients primarily displaying autogenous obsessions as opposed to reactive obsessions would display more severely disordered thinking/perception. We compared 15 OCD patients primarily displaying autogenous obsessions (AOs), 14 OCD patients primarily displaying reactive obsessions (ROs), 32 patients with schizophrenia (SPRs), and 28 patients with other anxiety disorders (OADs) with respect to thought disorders as assessed by the Comprehensive System of the Rorschach Inkblot Test. Results indicated that both AOs and SPRs displayed more severe thought disorders compared to ROs or OADs. Theoretical and clinical implications are discussed. © 2004 Wiley Periodicals, Inc. J Clin Psychol. [source] Treatment of obsessive-compulsive disorder in patients who have comorbid major depressionJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2004Jonathan S. Abramowitz Many patients who have obsessive-compulsive disorder (OCD) also meet criteria for additional diagnoses such as mood, anxiety, and personality disorders. The presence of severe depression, and major depressive disorder per se, impedes response to treatment for OCD that uses the best available treatments. In this article, the comorbidity data in OCD are reviewed, then the relationship between depression and OCD treatment outcome is reviewed. Next, the derivation and implementation of a treatment program specifically for depressed OCD patients are illustrated with a case example. The article closes with a discussion of implications and directions gleaned from this single case study. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Treatment of compulsive hoardingJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2004Sanjaya Saxena Compulsive hoarding and saving symptoms, found in many patients who have obsessive-compulsive disorder (OCD), are part of a clinical syndrome that has been associated with poor response to antiobsessional medications and cognitive-behavioral therapy (CBT). Specific CBT strategies targeting the characteristic features of the compulsive hoarding syndrome have had better results. This article provides an overview of the compulsive hoarding syndrome, a review of treatment approaches and their efficacy, a case presentation, and a detailed discussion of intensive, multimodal CBT for compulsive hoarding. New insights into the neurobiological characteristics of compulsive hoarding that might direct future treatment development are also presented. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Understanding and treating incompleteness in obsessive-compulsive disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2004Laura J. SummerfeldtArticle first published online: 10 SEP 200 Incompleteness,the troubling and irremediable sense that one's actions or experiences are not "just right",appears to underlie many of the symptoms of obsessive-compulsive disorder (OCD). Because incompleteness may reflect basic sensory-affective dysfunction, it presents a challenge to clinicians wishing to apply cognitive-behavioral treatments. In this article, I review ways of adapting well-demonstrated treatment principles to this condition. A case is presented and then used to discuss challenges in conducting cognitive-behavioral therapy with this population. Behavioral methods aimed at habituation (e.g., exposure and ritual prevention [ERP]) are probably more applicable than conventional cognitive techniques. However, even these may result in modest long-term gains; relapse is a probability if they are not actively practiced after treatment cessation. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Computer-aided CBT self-help for anxiety and depressive disorders: Experience of a London clinic and future directionsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2004Lina Gega This article describes a broad-spectrum, computer-aided self-help clinic that raised the throughput of anxious/depressed patients per clinician and lowered per-patient time with a clinician without impairing effectiveness. Many sufferers improved by using one of four computer-aided systems of cognitive behavior therapy (CBT) self-help for phobia/panic, depression, obsessive-compulsive disorder, and general anxiety. The systems are accessible at home, two by phone and two by the Web. Initial brief screening by a clinician can be done by phone, and if patients get stuck they can obtain brief live advice from a therapist on a phone helpline. Such clinician-extender systems offer hope for enhancing the convenience and confidentiality of guided self-help, reducing the per-patient cost of CBT, and lessening stigma. The case examples illustrate the clinical process and outcomes of the computer-aided system. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndromeJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Ahmad Ghanizadeh Abstract Background and Aim:, Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. Methods:, The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5,18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. Results:, About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. Discussion:, There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups. [source] The effectiveness of antidepressant medication in the management of behaviour problems in adults with intellectual disabilities: a systematic reviewJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 10 2007S. K. Sohanpal Abstract Background A comprehensive systematic review was performed to establish the current evidence base regarding the effectiveness of antidepressant medication for the management of behaviour problems in adults with intellectual disabilities. Method An electronic search of PsycInfo, Embase, Medline and Cinahl databases was conducted spanning the time period 1990 to October 2005 for primary trials. This was supplemented by hand searching and cross-referencing of relevant reviews. Strict scientific methodology requirements were formulated that the studies had to meet in order to merit inclusion in this review. Results One crossover randomized controlled trial in a small cohort, seven prospective uncontrolled trials and two retrospective studies were yielded in the search. Of these, one explored the effectiveness of the tricyclic antidepressant , clomipramine, and nine considered various selective serotonin reuptake inhibitors (SSRIs). Conclusion Evidence based primarily on a small number of either prospective or retrospective case studies that included a small number of participants and often used non-validated outcome measures for a short period of follow-up, suggests that antidepressants, particularly SSRIs, show improvement of aggression and self-injurious behaviour on average in less than 50% of cases and the rest show either no improvement or deterioration. The effect is most pronounced in the presence of an underlying anxiety or an associated diagnosis of obsessive-compulsive disorder. Most studies have highlighted the concern regarding adverse effects. [source] Social and Professional Support Needs of Families After Perinatal LossJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2005Marianne H. Hutti Perinatal loss has been associated with depression, anxiety, obsessive-compulsive disorder, suicide, marital conflict, and post-traumatic stress disorder. Nurses may provide professional support through teaching, role modeling, encouragement, counseling, problem solving, and other interventions. Nurses also may encourage more effective social support by helping significant others to provide willing, well-intentioned action that will produce a positive response in the bereaved couple. Interventions to increase professional and social support after perinatal loss are described. [source] Efficacy of treatments for patients with obsessive-compulsive disorder: A systematic reviewJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2009PMHNP (Lecturer)Article first published online: 2 APR 200, Yun-Jung Choi PhD Abstract Purpose: This systematic review examines the efficacy of pharmacological therapy for obsessive-compulsive disorder (OCD), addressing two major issues: which treatment is most effective in treating the patient's symptoms and which is beneficial for maintaining remission. Data sources: Seven databases were used to acquire articles. The key words used to search for the relative topics published from 1996 to 2007 were "obsessive-compulsive disorder" and "Yale-Brown obsession-compulsion scale." Based on the inclusion and exclusion criteria, 25 studies were selected from 57 potentially relevant studies. Conclusions: The effects of treatment with clomipramine and selective serotonin reuptake inhibitors (SSRIs: fluvoxamine, sertraline, fluoxetine, citalopram, and escitalopram) proved to be similar, except for the lower adherence rate in case of clomipramine because of its side effects. An adequate drug trial involves administering an effective daily dose for a minimum of 8 weeks. An augmentation strategy proven effective for individuals refractory to monotherapy with SSRI treatment alone is the use of atypical antipsychotics (risperidone, olanzapine, and quetiapine). Implications for practice: Administration of fluvoxamine or sertraline to patients for an adequate duration is recommended as the first-line prescription for OCD, and augmentation therapy with risperidone, olanzapine, or quetiapine is recommended for refractory OCD. [source] Traditional Healing and Its Discontents: Efficacy and Traditional Therapies of Neuropsychiatric Disorders in BaliMEDICAL ANTHROPOLOGY QUARTERLY, Issue 1 2004Robert Bush Lemelson In a discussion of patients suffering from obsessive-compulsive disorder (OCD) and/or Tourettes's Syndrome (TS), in Bali, Indonesia, traditional healing and psychiatric perspectives are used to highlight the power and weakness of each to treat these conditions. Given they are drawn from the same culture, should not indigenous explanatory models provide meaning and be more efficacious at relieving the suffering of people with OCD and TS-like symptoms? What if they provide an understandable meaning for patients but these meanings have no efficacy? Ethnographic data on Balinese models for illness are presented. Multiple data sources were used to frame the complex Balinese traditional healing systems. Forty patients were interviewed regarding their utilization of traditional healers, and healers were observed treating patients and interviewed regarding their treatment regimens and explanatory models. Traditional explanatory models for illness provide an understandable and integrated system of meaning for these disorders but are not successful in relieving symptomatology. Neurobiological approaches, traditional healing, and ethnographic methods are compared and contrasted to highlight the strengths and weaknesses of each in relation to issues of exegesis and efficacy, [obsessive-compulsive disorder, Tourette's Syndrome, traditional healing, Indonesia] [source] | ||||||||||||||||||||||||||||||||||