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Chapter 31. Obsessive-Compulsive Disorder

John H. Greist, M.D.; James W. Jefferson, M.D.
DOI: 10.1176/appi.books.9781585622986.258454

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Obsessive-compulsive disorder (OCD) is characterized by thoughts, images, or impulses that are often experienced as intrusive and inappropriate (obsessions) and by repetitive behaviors or mental acts that the person feels driven to perform to lessen their anxiety (compulsions) (Rasmussen and Eisen 1989). For chronic and severe disorders such as OCD, many treatments are attempted. Until recently, OCD was unresponsive to most remedies. Specific psychotherapeutic and pharmacological approaches, however, now have established efficacy for this condition.

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Figure 31–1. Sample rates of change with behavior therapy of an obsessive-compulsive disorder ritual.Source. Reprinted from Baer L: Getting Control: Overcoming Your Obsessions and Compulsions, Revised Edition. Boston, MA, Little, Brown, 2000, p. 53. Copyright 2000. Used with permission.

Figure 31–2. Mean change in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score: intent-to-treat analysis of drug minus placebo.Pooled standard error of change score was used in error bars (available for endpoint only).*12 weeks of treatment for fluvoxamine and sertraline.Source. Reprinted from Greist JH, Jefferson JW, Kobak KA, et al.: "Efficacy and Tolerability of Serotonin Transport Inhibitors in Obsessive-Compulsive Disorder: A Meta-Analysis." Archives of General Psychiatry 52:53–60, 1995. Copyright 1995, American Medical Association. Used with permission.

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