Obsessive-compulsive disorder: treatment and treatment resistance

Authors: Hood, Sean¹; Alderton, Deirdre²; Castle, David³

Source: Australasian Psychiatry, Volume 9, Number 2, June 2001 , pp. 118-127(10)

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Abstract:

Objective: To review the treatment options for obsessive-compulsive disorder (OCD), with particular reference to treatment resistance, and provide a guideline for clinicians managing these patients, drawing upon evidence from clinical trials and expert consensus.

Conclusions: The behavioural technique of exposure and ritual prevention (EX/RP) and serotonergic medications have emerged as effective standard treatments of OCD, although full symptom remission is rare. Predictors of poor and partial response to these treatments may reflect substantial underlying heterogeneity in OCD. Clinicians can now begin to apply psychological and pharmacological augmenting strategies that specifically target these heterogenous subgroups in an attempt to improve response. We offer a treatment algorithm for OCD derived from this understanding.

Keywords: obsessive-compulsive disorder; treatment; treatment resistance

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1440-1665.2001.00316.x

Affiliations: 1: Alma Street Centre, Fremantle Hospital and Health Service & Clinical Research Fellow, Psychopharmacology Unit, University of Bristol, England. 2: Alma Street Centre, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia. 3: University of Western Australia & Clinical Director, Alma Street Centre, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia.

Publication date: 2001-06-01