OCD Patients Who Fail on Meds Helped By Exposure Therapy

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Patients with obsessive-compulsive disorder who fail to improve with drug treatment benefit when exposure and response prevention (EX/RP) therapy is added to the regimen.

Carmen McLean, PhD, of the Center for the Treatment and Study of Anxiety at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, and colleagues enrolled 32 patients who received 17 weeks of exposure and response therapy after not responding sufficiently to risperidone. The therapy is cognitive behavior-based and involves a patient confronting triggers to obsessions in the hope it will stop them from performing the rituals.

At weeks 12 and 17, there was significant improvement in symptoms, with 78% of patients completing the therapy, with 53% of them considered treatment responders, the researchers reported in the Journal of Clinical Psychiatry. At a follow-up evaluation after 32 weeks, 34% were classified as excellent responders. In the follow-up period, other patients required changes to their medication, which led them to achieve excellent-response status as well.

“We found compared to patients who received medication or placebo, those who received EX/RP showed significantly more reductions in OCD symptoms and depression, as well as significantly more increases in insight, quality of life, and social function after only eight weeks,” McLean said in a statement.

OCD Patients Who Fail on Meds Helped By Exposure Therapy
By the end of the exposure and response prevention therapy treatment, more than half of the patients with OCD were considered excellent responders.

Patients with obsessive-compulsive disorder (OCD) can improve their symptoms significantly by adding exposure and response prevention therapy to their treatment regimen when common drug treatment options have failed, according to new research from psychiatrists at the Perelman School of Medicine at the University of Pennsylvania.

Exposure and response prevention therapy is a type of cognitive behavior therapy in which the patient is asked to confront triggers that give rise to their obsessions in order to refrain from performing the rituals in response to these obsessions. The study is published in the Journal of Clinical Psychiatry.

OCD is marked by the performing of "rituals" to decrease distress related to one's obsessions—such as excessive hand-washing to cope with a fixation on hand hygiene, for example.

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