Treatment

The treatment of OCD and Related Disorders in specific individuals should be determined by (1) the scientific evidence, (2) patient factors, (3) service factors, and (4) ethical considerations.

In this book, we have sought to distil the evidence base and provide clear guidelines on treatment for the various disorders. In terms of medication options, various jurisdictions have approved certain medications for the treatment of OCD and related disorders. In addition, scientific evidence may support non-approved medication options as well.

Patient factors that should be considered as a general principle when determining treatment choice include the nature and severity of symptoms, co-morbid medical and psychiatric conditions, any past treatments received and response to these, current medications, and patient/family preferences.

Availability of treatments, and waiting lists, also place pragmatic restraints on what can be offered, and this is likely to vary considerably depending on geographical location and context (service factors), which are often largely outside of the healthcare professional’s control.

Ethical considerations are always relevant, namely: non-maleficence (do no harm), beneficence (do good), and justice (appropriate and fair allocation of resources). In practice for clinicians, this means weighing the pros and cons of a given treatment and being sure to discuss these with the patient to facilitate informed decision-making.

Key References

  • • Blanco C, Olfson M, Stein DJ, et al. Treatment of obsessive- compulsive disorder by U.S. psychiatrists. J Clin Psychiatry. 2006 Jun;67(6):946-51.
  • • Castle DJ, Phillips KA. Obsessive compulsive spectrum of disorders: a defensible construct? Aust N Z J Psychiatry. 2006 Feb;40(2):114-20.
  • • Veldhuis J, Dieleman JP, Wohlfarth T, Storosum JG, van Den Brink W, Sturkenboom MC, Denys D. Incidence and prevalence of “diagnosed OCD” in a primary care, treatment seeking, population. Int J Psychiatry Clin Pract. 2012 Jun;16(2):85-92.
 
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