Documente Academic
Documente Profesional
Documente Cultură
OCD-ers when they try not to think of something, they think about it
more.
TREATMENT - clomipramine is superior to placebo., selective SRIs
are superior to placebo.
eg fluvoxamine, sertaline, paroxetine. high doses of sri meds 20-
250mg of various SRIs
OCD does not have a large placebo response. medication is helpful,
but does not reduce significantly, still can apply for more medicine.
clamipromine may pack a better punch.
HEVAVIORAL TREATMENT -
If someone is afraid, gradual form of exposure. can't overcome
without confrontation. most prevent avoidant behaviors. however,
anxiety increases and forms habituation over correction ensures
coping with situations.
most practice at high levels - our correction. Must tolerate something
worse than natural situations.
Exposure and ritual precautions for ocd
exposure in real life - prolonged confrontation with anxiety invoking
stimuli. eg contact with contaminates.
IMAGINAL EXPOSURE - prolonged imagined exposure and
confrontation with feared disasters. e.g. becoming ill with the
contamination.
Ritual prevention - blocking of compulsions. e.g. leaving the bathroom
without washing hands.
THESE THINGS ARE TOLERABLE!
people will generally listen to suggestions which may help them.
more response to behavioral therapy, but not always. this is average.
if you allow leeway, abstinence is the optimal result.
experience things with the patient.
SRI medications work sometimes quickly, for people who have never
had treatment.
is OCD really caused by the brain?
educate the patient, develop hierarchy, some situations alone,
monitor rituals, objective view, e.g. spouse, friend, relative, family,
friend, boss, etc. much encouragement, discussion of risk. recognize
risk, the imminent risk.
SUMMARY -
OCD is common, chronic, and disabling. - Major threat to public
health.
OCD is biological, behavioral, and a cognitive disorder.
SRI medications can be effective/are effective.
CBT is effective and may be an optimal first line treatment - some
evidence of first line treatment, also where SRI fails.