A woman comes to psychiatrist with history of spending a lot of time in washing her hands. She is distressed about it but says that she is not able to stop washing. This has staed to affect her social life as well. What is the best mode of treatment for her?
Obsessive compulsive disorder - Obsessive-compulsive disorder (OCD) is a condition characterized by obsessions and/or compulsions that the person feels driven to perform according to specific rules in order to prevent an imagined dreaded event. OCD is the fouh most common psychiatric disorder and is usually a chronic condition Obsessions - recurrent persistent thoughts, impulses, or images that enter the mind despite effos to exclude them Patient try to resists them Compulsions - Behavior on mental acts that follow obsession & reduce anxiety temporarily Both obsession and compulsion are ego dystonic Presentation m/c presentation - obsession of contamination followed by compulsions of washing Pathological doubts Intrusive thoughts Symmetry - compulsion of slowness Hoarding Depression is most common comorbidity Treatment - best - combination of pharmacotherapy and psychotherapy pharmacotherapy - SSRI PSYCHOTHERAPY - Brief cognitive behavioral therapy (CBT) based on exposure with response prevention is the treatment of choice, and can be delivered in a variety of ways: Brief individual CBT (up to 10 hours) with structured self-help materials CBT by telephone Group CBT
Cognitive behavioral therapy
Exposure and response prevention
Systematic desensitization
Pharmacological agents
Neurotic, Stress Related and Somatoform Disorders