Current Treatments of Obsessive-Compulsive Disorder

This "how-to" guide is written for the clinician who wants a quick grasp of current knowledge of treatment of obsessive-compulsive disorder (OCD). Each chapter not only serves as a critical review, but also addresses the advantages and pitfalls of each suggested treatment. The authors close each chapter with several case histories and a summary portraying the OCD patient and describe what it is like to treat these patients week after week. The opening chapter briefly reviews diagnostic considerations, emphasizing subtypes of OCD patients and differential diagnosis. The next three chapters provide a review of specific pharmacological treatment of OCD and present data on the efficacy of these agents. The authors outline the clinical use of clomipramine, fluoxetine and fluvoxamine and make recommendations for dosage and duration of treatment. Chapter five reviews the behavioural treatment approach and illustrates its application through an illustrative case example. The presentation and treatment of OCD in children is the focus of the sixth chapter, which also includes a discussion of landmark work in the neurobiology of OCD. Following sections present family therapy and an approach that brings together several families in a group setting. Next, treatment resistance is addressed, with emphasis on multidisciplinary approaches that have proved useful in overcoming this problem. Chapter ten grapples with the inherent moral dilemma in treating strictly religious OCD patients. The closing chapter outlines in brief some rare and unusual symptoms that respond to serotonergic drugs. Though not classified as OCD disorders in DSM-III-R, the underlying obsessions and compulsions described by these patients and their reponse to similar anti-obsessional agents would seem to put them in the realm of OCD. The overall aim of this volume is to provide an understanding of what these patients suffer and their eagerness to get well.