- Oxford Library Of Psychology
- The Oxford Handbook of Obsessive Compulsive and Spectrum Disorders
- Short Contents
- Oxford Library of Psychology
- About the Editor
- Phenomenology and Epidemiology of Obsessive Compulsive Disorder
- Phenomenology and Epidemiology of Body Dysmorphic Disorder
- Phenomenology and Characteristics of Compulsive Hoarding
- Phenomenology and Epidemiology of Tic Disorders and Trichotillomania
- Genetic Understanding of OCD and Spectrum Disorders
- Neuroanatomy of Obsessive Compulsive and Related Disorders
- Information Processing in Obsessive Compulsive Disorder and Related Problems
- The Role of Family and Social Relationships in OCD and Spectrum Conditions
- Personality Features of OCD and Spectrum Conditions
- Psychological Models of Obsessive Compulsive and Spectrum Disorders: <i>From Psychoanalytic to Behavioral Conceptualizations</i>
- Cognitive Approaches to Understanding Obsessive Compulsive and Related Disorders
- Assessing OCD Symptoms and Severity
- Assessing Comorbidity, Insight, Family and Functioning in OCD
- Pharmacological Treatments for Obsessive Compulsive Disorder
- Other Biological Approaches to OCD
- Exposure-Based Treatment for Obsessive Compulsive Disorder
- Cognitive Treatment for OCD
- Combining Pharmacotherapy and Psychological Treatments for OCD
- Additive and Alternative Approaches to Treating Obsessive Compulsive Disorder
- Treatment of Body Dysmorphic Disorder
- Treatment of Compulsive Hoarding
- Treatment of Tic Disorders and Trichotillomania
- OCD and Spectrum Conditions in Older Adults
- Obsessive Compulsive Spectrum Disorders in Children and Adolescents
- Cultural Issues in Understanding and Treating Obsessive Compulsive and Spectrum Disorders
- Future Research on Obsessive Compulsive and Spectrum Conditions
Abstract and Keywords
Progress in treating OCD has accelerated in recent years. Effective first-line treatments include behavior therapy and medications, with overwhelming evidence supporting the efficacy of serotonergic reuptake inhibitors (SRIs). Second-line medication treatments for OCD include augmentation of SRIs with neuroleptics, clonazepam, or buspirone, with limited support for other strategies at present. Alternative monotherapies (e.g., buspirone, clonazepam, phenelzine) have more limited supporting data and require further study. Behavior therapy, and perhaps cognitive therapy, is as effective as medication and may be superior in risks, costs, and enduring benefits. Future rigorous research is needed to determine which patients respond preferentially to which medications, at what dose, and after what duration. Emerging treatments include new compounds acting via serotonergic, dopaminergic, glutamatergic, and opioid systems.
Darin D. Dougherty, OCD Institute, McLean Hospital/Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA.
Scott L. Rauch, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA.
Michael A. Jenike, OCD Institute, McLean Hospital/Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA.
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