Obsessive-Compulsive Disorder

Current Science and Clinical Practice
1. Auflage 2012
ISBN: 978-0-470-71125-5
Verlag: Wiley

Buch, Englisch, 360 Seiten, Format (B × H): 175 mm x 246 mm, Gewicht: 703 g

Reihe: World Psychiatric Association

Obsessive compulsive disorder (OCD) remains one of the most challenging disorders of the brain.

Contemporary conceptualization and therapeutic strategies are undergoing a revolution as a result of new insights derived from modern technological advances. This book was conceived in order to present this revolution to the reader. It covers current theories regarding the etiology of OCD, what is known about the genetics of this disorder, evidence from neuroimaging and a discussion of potential endophenotypes. There is an evaluation of current treatment approaches for the disorder, encompassing psychological, psychopharmacological and physical interventions, as well as a discussion of treatment resistance. The book considers methodological issues, plus reviews of OCD in pediatric populations. A summary chapter highlights some potential research avenues, in a discussion of the future directions in OCD.

Rather than provide comprehensive coverage, repeating material from standard psychiatry textbooks, this book focuses on recent information and its application, distinguishing it from other titles.

If you work in children with OCD,
If you are interested in genetics, neurocognition or brain imaging,
If you work with patients and would like to improve your assessment in OCD and OCD Spectrum disorders, to update your therapeutic strategies and to get a handle on cutting edge developments in this intriguing field,
If you are planning a research project in OCD and would like to get some hints from people who are research leaders in this field and also learn about methodological issues specific to OCD research,

then this book will be a valuable resource.

A concise overview of the current state of the art in OCD assessment and treatment, including physical interventions and treatment resistance
Focuses on scientific advances (including specific methodological issues) and how they can inform and benefit clinical practice
Looks critically and broadly at the diagnostic classification, including the ongoing revision of the two major international systems
Written by an A-list team of experts in the field who have a track record of being engaging authors

Autoren/Hrsg.

Zohar, Joseph

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Neuropharmakologie, Psychopharmakologie
• Sozialwissenschaften Psychologie Allgemeine Psychologie Biologische Psychologie, Neuropsychologie
• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Pharmakotherapie, Psychopharmakotherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie

Inhaltsverzeichnis

List of Contributors xii

Introduction xvii

SECTION 1 ASSESSMENT AND TREATMENT

1 Assessment 3
Jose M. Menchon

Introduction 3

Detecting OCD 5

Screening in clinical interview 7

Structured interviews 8

Clinical assessment of obsessive-compulsive symptoms 9

Yale-brown obsessive-compulsive scale 10

Dimensional yale-brown obsessive-compulsive scale (DY-BOCS) 11

Leyton obsessional inventory (LOI) 12

Maudsley obsessional-compulsive inventory (MOCI) 13

Padua inventory (PI) 13

Obsessive compulsive inventory (OCI) 14

Insight 14

Rating insight 15

Assessment of the risk of suicide 17

Differential diagnosis, comorbidities and related disorders 18

Organic brain disorders 19

Schizophrenia 20

Depression 20

Hypochondriasis 20

Phobias 21

Tourette disorder and tic disorders 21

Obsessive-compulsive personality disorder (OCPD) 21

Body dysmorphic disorder (BDD) 21

Hoarding 22

Other disorders 22

Conclusions 22

References 23

2 Pharmacotherapy of obsessive-compulsive disorder 31
Eric H. Decloedt and Dan J. Stein

Introduction 31

Placebo-controlled studies of clomipramine 32

Placebo-controlled studies of fluvoxamine 32

Placebo-controlled studies of fluoxetine 33

Placebo-controlled studies of paroxetine 34

Placebo-controlled studies of sertraline 34

Placebo-controlled studies of citalopram/escitalopram 34

Placebo-controlled studies of venlafaxine 35

Improving early response in OCD 35

Special populations: children 36

Clomipramine 36

Fluvoxamine 36

Fluoxetine 36

Paroxetine 37

Sertraline 37

Citalopram 38

Meta-analyses 38

Tolerability of clomipramine and serotonin reuptake inhibitors 40

Optimal dose of treatment 41

Duration of treatment 42

Refractory OCD 43

Increased dose of SSRI 43

Augmentation of SSRI treatment with antipsychotics 44

Other drugs 45

Alternative modes of administration of SSRIs 46

Combining SRIs 46

Switching SSRIs 46

Adding psychotherapy 47

Future therapeutic options 47

Conclusion 48

References 48

3 Cognitive behavioural therapy in obsessive-compulsive disorder: state of the art 58
Martin E. Franklin, Addie Goss and John S. March

Theoretical models 58

Treatment 60

Exposure plus response prevention (ERP) 60

Cognitive therapies 63

ERP plus medication 63

OCD protocols 64

Assessment 64

Adult ERP protocol 65

Paediatric ERP protocol 67

Dissemination 67

Future research 69

Summary 69

References 70

4 Electroconvulsive therapy, transcranial magnetic stimulation and deep brain stimulation in OCD 75
Rianne M. Blom, Martijn Figee, Nienke Vulink and Damiaan Denys

Introduction 75

Electroconvulsive therapy 75

Transcranial magnetic stimulation 76

Mechanism of action 77

Efficacy of rTMS in OCD 77

Side effects and safety 84

Conclusion and future directions 85

Lesioning 85

Deep brain stimulation 86

Efficacy of DBS in OCD 86

Mechanism of action of DBS in OCD 92

Side effects of DBS in OCD 92

Follow-up treatment 94

Conclusions: DBS 94

Conclusion 94

Acknowledgements 95

References 95

5 Approaches to treatment resistance 99
Stefano Pallanti, Giacomo Grassi and Andrea Cantisani

Terminological problems and operational definitions 100

Pharmacological strategies in resistant OCD 103

Switching 103

Infusion therapy 104

Cognitive behavioural therapy 105

Serotoninergic agents 106

Dopaminergic agents 108

Glutamatergic agents 113

Opioids 115

Physical therapies 115

Electroconvulsive therapy (ECT) 115

Repetitive transcranial magnetic stimulation (rTMS) 116

Deep brain stimulation (DBS) 116

Family intervention 117

Conclusions and future perspectives 117

References 118

SECTION 2 CLINICAL SPOTLIGHTS

6 Subtypes and spectrum issues 135
Eric Hollander, Steven Poskar and Adriel Gerard

The obsessive-compulsive spectrum 135

Introduction 135

Cl

Über Autor(innen)

Zohar, Joseph
Joseph Zohar is Department Chair of the Division of Psychiatry at Chaim Sheba Medical Center, Tel Hashomer, Israel. He is also Professor of Psychiatry at the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. He is President of the European College of Neuropharmacology, Associate editor of the World Journal of Biological Psychiatry and International editor of CNS.

Dr. Zohar has received numerous awards, including: Fogarty International Research Fellowship Award, in 1984; A.E. Bennet Award for Clinical Research in 1986; European College of Neuropsychopharmacology – Lilly Neuroscience Award for Clinical Research in 1998; and World Federation Society of Biological Psychiatry on excellency in education in 2001.