Obsessive Compulsive Disorder (OCD) is a psychiatric disorder associated with symptom of recurring thoughts and unwanted thoughts, aggressive behaviour and the urge to repeat behaviour over and over again. OCD is caused by a confluence of factors like biological predisposition, faulty thought patterns and early childhood experiences (Abramowitz, Taylor & McKay, 2009). Various treatment options are available to treat the disorder. The main purpose of the paper is to conduct a literature review to discuss regarding the causes and treatment options for OCD. The literature review also provides a discussion regarding the effectiveness of one specific treatment.
According to (Abramowitz, Taylor & McKay, 2009), OCD is a severe condition occurring in late adolescence and it has broad range of psychological symptoms. As the symptoms of OCD are linked to various psychological domains, a research study by Leckman et al. (1997) focused on evaluating the correlation between these symptoms of OCD. The main purpose of investigation in this area was to define the best phenotype of OCD based on the presence of other co-morbid disorders. The Yale-Brown Obsessive Compulsive Scale symptom checklist was used to evaluate symptoms dimensions provided by the participants. 292 patients with OCD were the research participants and their symptom was analysed by the Yale-Brown Obsessive Compulsive Scale symptom checklist. The research gave good justification regarding the reasons for using the tool. The result findings revealed four sets of symptom dimension such as that of obsession and checking, symmetry and ordering, cleanliness and washing and hoarding. The results showed strong correlation between aggressive obsession and checking compulsion. However, the limitation was that the outcome was found to be inconsistent with other research literature. However, different correlations showed that OCD is a multidimensional and heterogeneous disorder. The benefit of this research finding is that it provides a good approach to assess the clinical severity of each symptoms and direct new research in this area. This may help in the development of advanced rating scale for the assessment of severity of OCD.
The review of research literature also demonstrates the impact of gender or sex on the expression of OCD symptoms. This can be said because effect of sex on symptom dimension was found and the symptom was found greater in men than in females while investigating about correlation between symptoms in the study by Leckman et al. (1997). However, this finding is limited by the publication date as it is too outdated. Review of research study by Mathis et al. (2011) showed gender differences in OCD by means of a literature review of research papers. This finding also gave similar findings as given by Leckman et al. (1997), as male patients were found more likely to present with early onset symptoms, greater social impairment and aggressive symptoms compared to females. In addition, cleaning symptoms are most commonly found in females. However, this understanding should be confirmed with genetic studies in the future. The significance of the research by Mathis et al. (2011) is that it may help in the elucidation of the etiology of OCD and implementation of relevant treatment for patients.
As OCD is a heterogeneous disorder, there are many treatment options for treating people with OCD. These include serotonin-reuptake inhibitors (SSRI), cognitive behavioural therapy (CBT), medications like D-cycloserine and a combination of both SRRI and CBT (Abramowitz, Taylor & McKay, 2009). CBT is considered the most common and effective method for treatment of OCD. It focuses on recovery of patient by changing the way they think and behave (Torp et al., 2015). In contrast, SSRI treatment involves providing OCD patients with SSRIs like Paraoxetine and Fluosetine. They act to reduce the severity and of obsessions and compulsions in patient. Research studies have proved the effectiveness of CBT and SSRIs for treatment of OCD. Patel and Simpson (2010) explain that SSRIs and CBT are two first line treatments for OCD. Both treatments have its benefits and weakness due to which preference for treatment differs. Patel and Simpson (2010) aimed to investigated about the preference of people regarding SSRIs, CBT or combination treatment. Data related to treatment preferences were collected from participants by choice experiment and rank-order preference. When forced to choose among three treatments, majority of participants selected combination treatment. The main rational for this was positive experience with treatment and the thinking that combination treatment would optimize the outcome. In rank-order preference, psychotherapy was the most preferred and deep brain stimulation was the least preferred treatment. The finding gave the idea that experience and complexity of treatment influenced treatment choices. The study gave unique idea regarding preference. However, the limitation of the work is that due to convenience sampling method, the research finding may not be applied to all setting.
To conclude, it can be said that OCD is a heterogeneous disorder and the literature review regarding the symptoms and treatment for OCD suggest that OCD patient present with variety of symptoms with varying degree of severity. Cognitive behavioural therapy and SSRIs are considered the first line of treatment however combination treatment is most effective to get positive outcome for patient. To ensure that patients utilize best treatment options, focusing on reducing the complexities in treatment choice is important.
Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. The Lancet, 374(9688), 491-499.
Leckman, J. F., Grice, D. E., Boardman, J., Zhang, H., Vitale, A., Bondi, C., ... & Goodman, W. K. (1997). Symptoms of obsessive-compulsive disorder. American Journal of Psychiatry, 154(7), 911-917.
Mathis, M. A. D., Alvarenga, P. D., Funaro, G., Torresan, R. C., Moraes, I., Torres, A. R., ... & Hounie, A. G. (2011). Gender differences in obsessive-compulsive disorder: a literature review. Revista Brasileira de Psiquiatria, 33(4), 390-399.
Patel, S. R., & Simpson, H. B. (2010). Patient Preferences for OCD treatment. The Journal of Clinical Psychiatry, 71(11), 1434–1439.
Torp, N. C., Dahl, K., Skarphedinsson, G., Thomsen, P. H., Valderhaug, R., Weidle, B., ... & Wentzel-Larsen, T. (2015). Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS). Behaviour Research and Therapy, 64, 15-23.