Obsessive compulsive disorder assessment

Pharmacologically, a principal point relates to the cost-effectiveness of the newer indications for SSRIs in the less common disorders such as obsessive—compulsive disorder and social phobia. These conditions do place a disproportionate burden on health-care systems, and clinical trials of the newer indications are convincing. However, no cost-effectiveness study has yet been petformed to assess this, and prescribing will continue to be based on individual clinical need. 

American Academy of Child and Adolescent Psychiatry (1998) Practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder./ Am Acad Child Adolesc Psychiatry 37 27S—45S. 

Giedd, J.N., Rapoport, J.L., Garvey, M.A., Perlmutter S., and Swedo, S.E. (2000) MRI assessment of children with obsessive compulsive disorder or tics associated with streptococcal infection. Am J Psychiatry 157 281-283. 

Baer L, Jenike MA, Ricciardi JN, et al. Standardized assessment of personality disorders in obsessive-compulsive disorder. Arch Gen Psychiatry 1990 47 826-830. 

First, a high index of suspicion for first episodes of depression should accompany the assessment of adolescent girls (Fig. 14—29), since this illness is frequently missed, and despite the lack of formal approval of antidepressants for use in anyone under the age of 18, the newer antidepressants are frequently used for this purpose, and their safety has been well established in children and adolescents for related conditions such as obsessive-compulsive disorder (see Chapter 5). Also, the use of oral... 

The aims of a prospective study in 113 consecutively hospitalized young patients (mean age 22 years) were to determine whether the severity of obsessive-compulsive symptoms differs during treatment with olanzapine or risperidone and to establish whether the duration of neuroleptic treatment is related to the severity of obsessive-compulsive symptoms (152). At baseline and week 6 assessments, obsessive-compulsive symptoms were found in 32 of 106 evaluable cases and 16 met DSM-IV criteria for obsessive-compulsive disorder, but there were no differences in patients taking olanzapine or risperidone. However, the severity of obsessive-compulsive symptoms was associated with the duration of treatment with olanzapine. 

Upon assessment it was evident to the social worker that Ron s symptoms were consistent with individuals who suffer from a type of anxiety disorder known as obsessive-compulsive disorder (OCD). The person who suffers from obsessive-compulsive disorder frequently has reoccurring obsessions (thoughts that interfere with action) and compulsions (behaviors that help ease current anxiety levels) that are related to the traumatic event. In OCD, the fourth most common psychiatric disorder in the United States, there appears to be a wide spectrum of symptoms (Cohen Steketee, 1998). These symptoms can range from mild to severe, yet if left untreated can impair an individual s previous level of functioning at work, school, or at home (De Silva Rachman, 1998). 

Monoamine oxidase inhibitors, such as SSRIs, have been shown to be effective in the treatment of depression, and they have become among the most widely used prescription drugs in the United States. Prozac is used not only to treat major depressive disorders but also bulimia nervosa, obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder. Multiple serotonin receptor subtypes are involved. Specific serotonin receptor subtype agonists and antagonists have been radiolabeled with positron-emitting tracers to assess the state of the serotonergic system. 

Chapter S6 Obsessive compulsive disorder fOCDf Preparation Assessment... 

Veale, D., Freeston, M., Krebs, G., Heyman, I. and Salkovskis, P (2009) Risk assessment and management in obsessive-compulsive disorder. Advances in Psychiatric Treatment, 15 (5), 332-343. 

In addition, patients with body dysmorphic disorder experience a preoccupation with an imagined defect in appearance that leads to repetitive checking behaviors to assess their appearance. The symptoms of body dysmorphic disorder, essentially equivalent to the obsessions and compulsions of OCD, have led some to propose that the former syndrome is not a distinct disorder but a subtype of the latter. Again, a key distinguishing factor is that OCD will typically have been associated with some other nonsomatic obsession during the course of the illness. 

Among the many self-report instruments that exist, some, such as the Multidimensional Anxiety Scale for Children (MASC March et ah, 1997) and the Screen for Anxiety-Related Emotional Disorders (SCARED Birmaher et ah, 1997 1999), assess a broad range of anxiety symptoms, while others assess one specific disorder or domain of anxiety (e.g., obsessive and compulsive behaviors, social anxiety, worry, fears, etc.). 

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