The Yale Brown Obsessive Compulsive Symptom Scale Checklist (YBOCS-SC) helps in the diagnosis of OCD. This scale consists of various queries regarding the OCD, and based on the patient characteristic, a score ranging from 1 to 4 is given. Scores in as many as 13 categories are recorded and totaled and the mean YBOCS-SC score is obtained (Stewart, 2008). Radiographs of the brain help to provide further evidence in the role of the cortical-striatal-thalamic system in the development of the OCD symptoms.
Studies have demonstrated that several parts including the striatal ventricles, third ventricles, corpus, genu, anterior cingulate cortex, caudate glx, thalamus, globus pallidus, etc, are affected in OCD (MacMaster, 2008). The differential diagnosis process helps to rule out OCD from similar disorder such as delusions, schizotypy, psychotic disorder, hallucinations, etc. In delusions, the insight and resistance are lost; whereas in OCD, the obsessions and the compulsions seems rather irrational (C. P, 2007). Treatment
As the condition of OCD is multidimensional, treatment should also be multidimensional to ensure that the effectiveness and the benefits to the patient are improved. It is very important that the very objectives of the treatment are established before actually initiating the treatment (Stein, 2006). The psychiatrist may choose to improve the quality of life of the patient, help reduce the signs and symptoms, improve patient cooperation, improve adaptation to stress, educate and motivate the patient, etc. The treatment needs to be conducted in a safe environment, either at the hospital, home or an outpatient setting.
The patient adherence needs to be closely decided, as high costs, difficulty in obtaining insurance, poor effectiveness of the medications, higher number of side-effects, poor effectiveness of the psychotherapy, etc, seem to reduce the patient adherence and cooperation. The most commonly utilized treatment measures in OCD include short-term administration of medications and psychotherapy. The most commonly utilized drug is an SSRI and the most often used therapy is Cognitive behavior therapy (CBT). CBT helps the patient to change their pattern of thinking and ensure that the obsessions and compulsions are corrected (Lambert, 2008).
One of the subjects discussed under CBT includes exposure and response prevention. In this treatment, the individual is purposefully put in a situation where they would develop obsessional thinking and produce compulsions. The therapist would help to identify the apprehension of the patient and accordingly correct the behavior (JAMA, 2004). CBT effectively reduces obsessional thoughts and relieve discomfort, thus helping to improve functioning and relationships with others (Purdon, 2004). With SSRI’s, an improvement may be obtained from 4 weeks to 10 weeks. Antipsychotic drugs may be effective along with CBT in case SSRI do not seem to work.
Usually, if one SSRI does not work, another drug belonging to the same group should be selected. After treating the patient for a few months, the drug dosage can be slowly tapered off over one to two months duration (Lambert, 2008). The environment changes including family accommodation plays a very important role in OCD treatment. Studies have shown that as the condition was more severe, the family accommodation increased (Merlo, 2009). Conclusion OCD often seems to be a serious mental disorder, characterized by the development of a wide range of obsessions and compulsions.
Patients suffering from the disorder require psychiatric care in the form of evaluation, psychotherapy, administration of antidepressants and close monitoring and follow-up. It may be very difficult to predict the outcome of OCD as the current data available seems to be rather insufficient. Usually, if the disease is severe and tends to affect functioning significant, the outcome of the disorder may be poor (Ginsburg, 2008). Niendam et al (2009) did not consider OCD was associated with a significant risk to undergo conversion to psychosis.
However, youth having OCD or OCD-like symptoms, are at the risk for depression, suicidal ideation, etc (Niendam, 2009). Hence prompt diagnosis and treatment of the condition is recommended. Each case of OCD needs to be closely monitored and followed up. Bibliography Ayuso-Mateos, J. L. (2000). Global burden of obsessive-compulsive disorder in the year 2000. World Health Organization Global Program on Evidence for Health Policy (GPE) , http://www. who. int/healthinfo/statistics/bod_obsessivecompulsive. pdf. Behave Net (2009). DSM-IV: Obsessive Compulsive Disorder (OCD), Retrieved March 24, 2009, from Behavenet: http://www. behavenet. com/capsules/disorders/o-cd. htm. Geller, D. A. (2006).
Obsessive-Compulsive and Spectrum Disorders in Children and Adolescents. Psychiatric Clinics of North America , http://www. mdconsult. com/das/article/body/127770514-2/jorg=journal&source=MI&sp=16170823&sid=819938776/N/532554/1. html? issn=0193-953X Ginsburg, G. S. Et al (2008). Predictors of treatment response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry, 47(8):868-78. http://www. ncbi. nlm. nih. gov/pubmed/18596553? ordinalpos=33&itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel. Pubmed_DefaultReportPanel. Pubmed_RVDocSum