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OCD is in many ways a homogeneous disorder. The disorder has a prevalence of around 2% to 3% of the population, and this prevalence is likely underestimated in many different countries / and descriptions of obsessions and compulsions have been remarkably consistent over time and place. Neurobiological studies have consistently found evidence that cortical-striatal-thalamic-cortical (CTSC) circuits play a crucial role in mediating the disorder and treatment research has invariably demonstrated that serotonin reuptake inhibitors selectively reduce the symptoms of OCD (Stein, Andersen, & Overo 2007; O'Connor, Todorov, Robillard, Borgeat, & Brault 1999).
The most common treatments for OCD are pharmacological and cognitive behavioral interventions. According to the American Psychiatric Association treatment practice guidelines for OCD, selective serotonin reuptake inhibitors (SSRIs) are considered first-line treatments for OCD. However, SSRIs are often associated with delayed onset of therapeutic effect (8 -- 12 weeks), only partial symptom reduction, and response failure or intolerability in 40% to 60% of patients. Pharmacological options for SSRI refractory cases include increasing drug dose, changing to another SSRI or clomipramine, combining SSRIs, or changing the mode of drug delivery. Augmentation with second-generation antipsychotics has demonstrated efficacy as a second-line treatment (Berlin, Hamilton & Hollander, 2008).Obsessive-compulsive disorder shows a slow, gradual improvement, which starts within a few days after the initiation of treatment and continues for months thereafter. Published consensus guidelines consider an adequate SRI trial in OCD to consist of 10 -- 12 weeks with at least 4 -- 6 at the maximum tolerated dose (Dell'Osso, Altamura, Mundo, Marazziti, & Hollander, 2007).
The addition of typical and atypical antipsychotics in patients with OCD resistant to SRIs has been reported as a useful augmentation strategy. Although antipsychotic mono-therapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as concomitant medications have proven to be effective in several case series and pilot clinical trials. The objective of this case series was to evaluate effectiveness of risperidone as add on therapy to current SRIs treatment in OCD refractory to treatment patients. Results indicated that Risperidone as add on therapy to SRI in moderate-severe, refractory to treatment OCD patients, may be an effective and safe strategy (Arias- Horcajadas, Soto, Garcia-Cantalapiedra, Rodriguez, Morales & Salgado 2006).
It is evident through this compilation of data that amongst the most effective treatments include SRIs, this does not go without noting that it too has been noted in the readings that there are patients that SRIs do not show to be an effective method. In these instances cases support the use of various antipsychotics mentioned in this essay. One thing is certain there are many facets to this disorder that still are not completely clear and understood. Though there are effective methods researchers indicated that there are more people that go undiagnosed and untreated.
Arias Horcajadas, F., Soto, J., Garcia-Cantalapiedra, M., Rodriguez Calvin, J., Morales, J., & Salgado, M. (2006). [Effectiveness and tolerability of addition of risperidone in obsessive-compulsive disorder with poor response to serotonin reuptake inhibitors]. Actas Espanolas De Psiquiatria, 34(3), 147-152. Retrieved from MEDLINE with Full Text database.
Berlin, H., Hamilton, H., & Hollander, E. (2008). Experimental therapeutics for refractory obsessive-compulsive disorder: translational approaches and new somatic developments. The Mount Sinai Journal Of Medicine, New York, 75(3), 174-203. Retrieved from MEDLINE with Full Text database.
Burgy, M. (2001). The Narcissistic Function in Obsessive-Compulsive Neurosis. American Journal of Psychotherapy, 55(1), 65. Retrieved from MasterFILE Premier database.
Dell'Osso, B., Altamura, A., Mundo, E., Marazziti, D., & Hollander, E. (2007). Diagnosis and treatment of obsessive-compulsive disorder and related disorders. International Journal Of Clinical Practice, 61(1), 98-104. Retrieved from MEDLINE with Full Text database.
Jane A., F. (n.d). Obsessive-compulsive disorder. The Gale Encyclopedia of Mental Disorders, 2685-691. Retrieved from Gale: Gale Virtual Reference Library (PowerSearch) database.
Obsessive-Compulsive Personality Disorder History and Theoretical Perspective. (2006). Retrieved from http://www.health.am/psy/more/ocpd_history_and_theoretical_perspective/
O'Connor, K., Todorov, C., Robillard, S., Borgeat, F., & Brault, M. (1999). Cognitive-behavior therapy and medication in the treatment of obsessive-compulsive disorder: a controlled study. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 44(1), 64-71. Retrieved from MEDLINE with Full Text database.
Stein, D., Andersen, E., & Overo, K. (2007). Response of symptom dimensions in obsessive-compulsive disorder to…[continue]
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These studies show the importance of confronting feared stimuli for extinguishing anxiety. However, at the same time, other research has found that the cognitive methodology has had equal results to the ERP in OCD treatment. Hackman and McLean report that they have as positive results with thought-stopping as those found with ERP. Once again, however, the number of studies has been very small (Abromowitz). It has only been in the
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" (p. 12) According to Cromer (2005) the literature that addresses the relationship between stressful life events and obsessive compulsive disorders does provide some degree of support implicating traumatic life-stress as being a factor in the onset and maintenance of the obsessive compulsive disorders however the exact relationship between the SLE and OCD "remains an empirical questions" specifically relating to "traumatic negative life events" (2005; p.13) Most of studies in
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