A comparative study of family-based and patient-based behavioural management in obsessive-compulsive disorder

Article Abstract:

It has been shown that the family members of a person suffering from obsessive-compulsive disorder (OCD) may play a significant role in maintaining the patient's symptoms. For example, a person obsessed with cleanliness may have grown up in an environment where cleanliness was stressed tyrannically. In India and other oriental cultures, the role and influence of the family are believed to be more significant than in many western cultures. To evaluate whether the family members of OCD patients could be helpful in the patient's therapy, 30 outpatients between 18 and 58 years of age, who had been diagnosed with OCD according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), were divided into two groups. Both groups were given assignments involving self-observation, relaxation therapy, systematic desensitization, and response prevention. The family members of patients in group A were instructed in supervision of the assignments, as well as how to act as a cotherapist in giving support; the families of patients in group B were given no such instructions. Following treatment, it was found that in areas such as anxiety, obsessions, depression, and social adjustment in family interaction and occupation, patients in group A were significantly improved over those in group B. These findings indicate that the family can be of substantial use in the outpatient treatment of OCD, especially in cultures where family relationships are still important. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Care and treatment, Evaluation, Family psychotherapy, Family counseling

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Clusters of obsessive-compulsive phenomena in obsessive-compulsive disorder

Article Abstract:

The prevalence of obsessive-compulsive disorder (OCD) is thought to be about 1 to 4 percent in psychiatric patients and possibly about 2.6 percent in the general population. The identification of groups, or clusters, of symptoms that distinguish patients with OCD from others has not been made. Records of 160 patients diagnosed with OCD were reviewed and data regarding symptoms were recorded using a check-list of 37 symptoms. Seven clusters of symptoms emerged: checking behavior (e.g., repeatedly checking the stove to be sure the gas is off), washing, past (e.g., thoughts of the past), embarrassing behavior, aggression, avoiding, and depression. The most prominent of these clusters were checking, washing, past, and embarrassing behavior. Further analysis revealed that 89 percent of subjects could be fitted into a primary cluster, with slightly less than half of these patients fitting into at least one other cluster as well. While these results are important in that they confirm the presence of some clusters and suggest additional clusters, OCD changes over time in a given patient, necessitating longitudinal research to provide a clearer picture of OCD in its full spectrum of symptomatology. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Diagnosis, Diagnosis, Differential, Differential diagnosis, Compulsive personality disorder

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Obsessive slowness revisited

Article Abstract:

Obsessive-compulsive disorder is well-documented. There have also been reports of a form of obsessive-compulsive disorder called obsessive slowness. In obsessive slowness, slow, habitually late, behavior is reported as a primary condition; the slowness and lateness is not due to other obsessive-compulsive traits, such as repeated washing or checking behavior. A total of 665 patients who exhibited obsessive-compulsive traits were identified, and the hospital records of these patients were examined. Investigation revealed that 22 patients seemed to have slowness as a significant problem, but in only one patient was slowness not attributable to other obsessive-compulsive traits. This man was habitually slow and late without rituals or ruminations. Twenty of the 22 cases of problem slowness were men, compared with about an even split between men and women with general obsessive-compulsive disorder. The average age of onset was 19 years. There was evidence of pre-natal or delivery problems in 27 percent of the 22 patients. Psychiatric illness was present in 41 percent of the families. It is not clear why this slowness behavior is more prevalent among men. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Demographic aspects

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