Obsessive-compulsive disorder cognitive-behavioral therapy

Rosenberg, D.R., Benazon, N.R., Gilbert, A., Sullivan, A., and Moore, G.J. (2000) Thalamic volume in pediatric obsessive-compulsive disorder patients before and after cognitive behavioral therapy. Biol Psychiatry 48 294-300. 

FIGURE 39.2 Treatment algorithm for pediatric obsessive-compulsive disorder (OCD). In adjusting cognitive behavior therapy (CBT), increase frequency or intensity, or alter the setting or format, e.g., have it be home based or day treatment. CMI, clomipramine DMI, desipramine NT, nortriptyline SSRI, selective serotonin reuptake inhibitor (fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram). 

During all phases of treatment, education, supportive therapy, and, at times, more specific types of psychotherapy are essential for a satisfactory outcome. For example, interpersonal therapy can complement adequate maintenance antidepressant treatment, possibly diminishing the frequency of episodes (see the section Role of Psychosocial Therapies in Chapter 7), and cognitive-behavioral techniques in combination with antiobsessive agents (e.g., clomipramine) can improve the quality of life for patients with obsessive-compulsive disorder, minimizing time spent on disabling rituals (see the section Obsessive-Compulsive Disorder in Chapter 13). 

O Connor K, Todorov C, Robillard S, et al. Cognitive-behavior therapy and medication in the treatment of obsessive-compulsive disorder a controlled study. Can J Psychiatry 1999 44 64-71. 

Simpson HB, Kozak M. Cognitive-behavioral therapy for obsessive-compulsive disorder. J Psychiatr Pract 2000 6 59-68. 

Behavioral therapies and cognitive therapies are commonly less effective for the treatment of panic disorder and obsessive compulsive disorder than are the SSRIs. 

FIGURE 70-2. Algorithm for management of obsessive-compulsive disorder in adults. A. Overall approach to treatment. B. Pharmacotherapeutic approach to treatment. CBT, cognitive behavioral therapy SSRI, selective serotonin reuptake inhibitor. (Derived from Expert Consensus Panel for Obsessive-Compulsive Disorder and American Pharmaceutical Association. )... 

Pharmacotherapy is only one of several treatment options for PTSD, especially in view of the great success of cognitive-behavioral therapy (CBT). Medication may be a good choice when patient acceptability of such an approach is high, when comorbid conditions are present that are responsive to pharmacotherapy (e.g. depression, panic disorder, social phobia, and obsessive-compulsive disorder), or when CBT is not applicable. ... 

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