Clinical Pearls for Alternative Treatments

  • • For OCD, alternative treatments should be considered as adjunctive to CBT or SRI therapy.
  • • N-acetylcysteine is an effective treatment for adults with Trichotillomania.
  • • Acupuncture, exercise, and yoga can be useful in improving mood and anxiety states for patients with OCD and related conditions, but should not be regarded as the first-line treatments.

Key References

• Sarris J, Camfield D, Berk M. Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (OCD) and the OCD spectrum: a systematic review. J Affect Disord. 2012 May;138(3):213-21.

Hospitalization, Day Treatments, and Residential Treatments

Inpatient treatment and partial hospitalization programs have shown some benefit for patients with severe, treatment-refractory

OCD. These types of programs are only available at a few sites worldwide. For OC disorders apart from OCD, research is scant and tailored programs are even rarer.

Hospitalization

Hospitalization is largely called for when acute stabilization is needed. This may be the case for OCD patients with co-occurring depression who become suicidal or in the case of OCD patients who cannot manage any self-care (or food intake) due to the severity of their illness. Hospitalization is usually of short duration (i.e., a few days). In general, the types of therapies provided in most inpatient facilities do not directly treat OCD symptoms. As such, the patient will not be having their OCD directly addressed. For some, the OCD symptoms may actually worsen as they are prevented from engaging in compulsions but without the benefit of having therapist-directed lessons in cognitive restructuring.

 
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