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Section 1: Psychological treatments for OCD

(1.1) Section 1: Psychological treatments for OCD

(1.2) Aim of treatment

(1.3) Psychological treatment

(1.4) Why do people perform compulsions?

(1.5) Why do people perform compulsions?

(1.6) ERP treatment

(1.7) Graded exposure

(1.8) Graded exposure

(1.9) Response prevention

(1.10) Effectiveness of treatment

(1.11) Outcome of ERP

(1.12) Cognitive therapy

(1.13) Cognitive therapy

(1.14) Cognitive therapy

(1.15) Self-help treatment for OCD

(1.16) ERP and obsessive ruminations

(1.17) Section 1: Recap

(1.18) Section 1: Summary

 

Section 2: Pharmacological treatment

(2.1) Section 2: Pharmacological treatment

(2.2) Pharmacological treatment

(2.3) Clomipramine

(2.4) Selective serotonin reuptake inhibitors

(2.5) Figure 1: Placebo-controlled studies of fixed doses of SSRI

(2.6) Effectiveness of SSRI treatment

(2.7) Side-effects of SSRI treatment

(2.8) Sexual side-effects of SSRI treatment

(2.9) Management approaches

(2.10) Management approaches

(2.11) Long-term treatment and relapse prevention

(2.12) Treatment guidelines

(2.13) Relapse prevention – a realistic goal for therapy

(2.14) Table 1: Double-blind studies of relapse prevention

(2.15) Double-blind studies of relapse prevention

(2.16) Double-blind studies of relapse prevention

(2.17) Combining drug treatment and psychological treatment (ERP and CBT)

(2.18) Combining drug treatment and psychological treatment (ERP and CBT)

(2.19) Combining drug treatment and psychological treatment (ERP and CBT)

(2.20) Combining drug treatment and psychological treatment (ERP and CBT)

(2.21) Does adding CBT to SRI protect against relapse after drug discontinuation?

(2.22) Section 2: Recap

(2.23) Section 2: Summary

 

(3.1) Section 3: Treatment-resistant OCD

(3.2) Treatment-resistant OCD

(3.3) Treatment-resistant OCD

(3.4) Table 2: Possible actions in ERP-resistant OCD

(3.5) Danger ideation reduction therapy (DIRT)

(3.6) Cognitive restructuring

(3.7) Filmed interviews

(3.8) Corrective information

(3.9) Microbiological experiments

(3.10) Probability of catastrophe

(3.11) Attentional focusing

(3.12) Table 3: Evidence-based psychopharmacological strategies for pharmacological treatment-resistant OCD

(3.13) Switch to another SSRI

(3.14) Increasing the dose

(3.15) Increasing the dose

(3.16) Figure 2: Practice guideline for the treatment of patients with OCD

(3.17) Combining SSRIs and antipsychotics

(3.18) Combining SSRIs and antipsychotics

(3.19) Change to a selective serotonin noradrenaline reuptake inhibitor

(3.20) Changing administration to intravenous

(3.21) Changing administration to intravenous

(3.22) Combining clomipramine and an SSRI

(3.23) Other strategies for treatment-resistant OCD

(3.24) Other strategies for treatment-resistant OCD

(3.25) Other strategies for treatment-resistant OCD

(3.26) Figure 3: SRI-resistant OCD – a pharmacotherapy algorithm

(3.27) Section 3: Recap

(3.28) Section 3: Summary

 

Section 4: Better services for OCD

(4.1) Section 4: Better services for OCD

(4.2) NICE Guidelines

(4.3) Figure 4: NICE (2006) OCD Guidelines – key priorities

(4.4) NICE Guidelines

(4.5) Figure 5: Stepped Care Model

(4.6) Quantifying functional impairment in OCD

(4.7) Quantifying functional impairment in OCD

(4.8) Mild functional impairment

(4.9) Moderate functional impairment

(4.10) Severe functional impairment

(4.11) Further management

(4.12) British Association for Psychopharmacology guidelines

(4.13) British Association for Psychopharmacology guidelines

(4.14) The National Commissioning Group for Highly Specialist Services (NCGHSS)

(4.15) Services for the treatment of refractory OCD or body dysmorphic disorder (BDD)

(4.16) Services for the treatment of refractory OCD or body dysmorphic disorder (BDD)

(4.17) Hertfordshire Partnership NHS Trust

(4.18) South West London and St George’s Trust

(4.19) South London and Maudsley Trust

(4.20) The Priory Hospital, North London

(4.21) Section 4: Recap

 

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© 2010 Royal College of Psychiatrists