treating OCD Flashcards
what are the three treatments of OCD?
-drug therapies
-psychosurgery
-CBT
what are biological treatments based on?
correcting biological abnormalities that are causing OCD
how do drugs treat OCD?
-anti-depressants, eg SSRIs, to elevate serotonin levels, and cause the orbital frontal cortex to function at a normal level
-children aged 6 given sertraline, aged 8+ given fluvoxamine
-treatment usually lasts 12-16 weeks
-anxiolytic drugs also used to lower anxiety
-antipsychotics lower dopamine, also useful but only typically given if SSRIs are ineffective
what was koran, ringold and elliott’s 2000 research on drug therapies?
-10 adult OCD who didn’t respond to 60mg a day of fluoxetine for 10 weeks
-administration of fluoxetine continued but added 2.5mg of olanzapine daily for 2 weeks, then 5mg daily for 2 weeks, then 10mg for 4 more weeks
-9 completed the trial, 6 patients had significant weight increase
-simultaneous drugs seemed to be effective as the mean Y-BCOS score decreased
-double-blind is needed to confirm results
-60% put on weight which could cause psychological harm
-supports bio explanation
research on drug therapies
-soomro et al 2008 - reviewed 17 studies of SSRIs vs placebos involving 3097 patients, found SSRIs were moderately effective in short term treating
evaluate drug therapies
-drugs don’t ‘cure’ OCD, but they allow a normal lifestyle
-side-effects, eg irritability, sleep pattern disturbance etc
-antidepressants may be more suited to adults who can tolerate side effects
-not sure if they reduce obsessive symptoms or lessen depressive symptoms that accompany the disorder
-widely used bcs they’re cheap, dont require a therapist and are user-friendly
-risk of side effects could increase suicidal thinking
what is psychosurgery?
destroying brain tissue to disrupt the corticostriatal circuit by using radio-frequency waves, effecting the orbital frontal cortex, the thalamus and the caudate nucleus brain areas
recent movement towards using deep-brain stimulation, involves using magnetic pulses on the supplementary motor area of the brain, associated with blocking irrelevant thoughts/obsessions
research on psychosurgery
-richter et al 2004 - 30% of ps had a 35%+ reduction of symptoms, but there were occasional complications, including urinary incompetence and seizures
evaluate psychosurgery
-has a relatively small success rate and can have side-effects
-only used on severe forms of OCD that don’t respond to other treatments, where there’s a risk of suicide
-around 10% of sufferers get worse over time, so psychosurgery can be seen as a valid treatment
how does CBT treat OCD?
-focuses on changing obsessional thinking
-can be done with habituation training (HT) (reliving irrational thoughts to reduce anxiety)
-intrusive thoughts are shown to be normal, and thinking isn’t the same as doing
-taught to assess the actual likelihood of risks occurring
research on CBT
-O’Connor et al 1999 - effectiveness of combining CBT and drugs, 4 groups (CBT+D, CBT, D, none) all groups except ‘none’ improved, but most symptom reduction occurred in CBT+D
-jonsson + hougaard 2009 - CBT was more effective than drugs in reducing symptoms
evaluate CBT
-acknowledged to be more effective and not have side effects
-isn’t suitable for ps who lack communication skills
-dont ‘cure’ OCD but reduce anxiety and symptoms (esp with drug therapy first)
-quicker than drug therapy (usually have to take meds for 12 months)
