Search results for ‘Subject term:"obsessive compulsive disorders"’ Sort:
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National service for adolescents and adults with severe obsessive-compulsive and body dysmorphic disorders
- Authors:
- DRUMMOND L. M., et al
- Journal article citation:
- Psychiatric Bulletin, 32(9), September 2008, pp.333-326.
- Publisher:
- Royal College of Psychiatrists
National guidelines for the assessment and treatment of obsessive-compulsive disorder (OCD) and body dysmorphic disorder were published in 2005 by the National Institute for Health and Clinical Excellence (NICE). Local services are unable to treat a small but significant number of the most severely ill patients successfully, and the guidelines recommend that such patients should have access to highly specialised care. From 1 April 2007, the Department of Health decided to centrally fund treatment services for severe, chronic, refractory OCD and BDD. The authors describe a new National Service for Refractory OCD; its rationale, treatments offered, referral criteria and expected clinical outcomes. initial results from one centre show an average 42% reduction in OCD symptoms at the end of treatment. The operational challenges and potential generalisability of this model of healthcare delivery are discussed. The authors present a summary of the progress made so far in establishing a new, coherent National Service for Refractory OCD, 18 months after the NICE guideline was published. The aim of the paper is to educate clinicians about the service and describe its rationale, treatments offered, referral criteria and expected clinical outcomes.
Community model in treating obsessive-compulsive and body dysmorphic disorders
- Authors:
- DRUMMOND L. M., et al
- Journal article citation:
- Psychiatric Bulletin, 32(9), September 2008, pp.336-340.
- Publisher:
- Royal College of Psychiatrists
In November 2005, the National Institute for Health and Clinical Excellence published guidelines for the treatment of obsessive-compulsive disorder (OCD) and body dysmorphic disorder. These guidelines incorporated a stepped care approach with different interventions advised throughout the patient pathway. South West London and St George’s Mental Health NHS Trust devised a system of expert clinicians with special expertise in OCD/body dysmorphic disorder to help deliver this model of care. To aid the delivery of service it was decided to operationalise the definitions of severity of OCD/body dysmorphic disorder at each of the stepped-care levels. Examples are given as to how this has been applied in practice. Outcome is presented in terms of clinical hours in the first year of operation. In total, 108 patients were referred to the service in the first year. Many of these patients were treated by offering advice and support and joint working with the community mental health team and psychotherapy in primary care teams who had referred. Sixty-eight patients were treated by a member of the specialist service alone and 57 of these suffered from severe OCD. Outcome data from these 57 patients is presented using an intention-to-treat paradigm. They showed a clinically and statistically significant reduction in OCD symptoms after 24 weeks of cognitive-behavioural therapy comprising graded exposure and self-imposed response prevention. The mean Yale-Brown Obsessive Compulsive Scale score dropped from 28 (severe OCD) to 19 (considerable OCD). Depressive symptoms on the Beck Depression Inventory also decreased by an average 24% over the same period.
Brain activation in paediatric obsessive–compulsive disorder during tasks of inhibitory control
- Authors:
- WOOLEY James, et al
- Journal article citation:
- British Journal of Psychiatry, 192(1), January 2008, pp.25-31.
- Publisher:
- Cambridge University Press
Obsessive–compulsive disorder (OCD) may be related to a dysfunction in frontostriatal pathways mediating inhibitory control. However, no functional magnetic resonance imaging (fMRI) study has tested this in children. Event-related fMRI was used to compare brain activation in 10 adolescent boys with OCD with that of 9 matched controls during three different tasks of inhibitory control. During a ‘stop’ task, participants with OCD showed reduced activation in right orbitofrontal cortex, thalamus and basal ganglia; inhibition failure elicited mesial frontal underactivation. Task switching and interference inhibition were associated with attenuated activation in frontal, temporoparietal and cerebellar regions. These preliminary findings support the hypothesis that paediatric OCD is characterised by a dysregulation of frontostriatothalamic brain regions necessary for motor inhibition, and also demonstrate dysfunction of temporoparietal and frontocerebellar attention networks during more cognitive forms of inhibition.
Treasures, trash and tenure: hoarding and housing risk
- Author:
- SLATTER Michele
- Journal article citation:
- People Place and Policy Online, 2(1), 2008, Online only
- Publisher:
- Sheffield Hallam University
- Place of publication:
- Sheffield
Hoarding, whether or not linked with squalor and self-neglect, can exact a high price on the well-being of the hoarder and the resources of agencies that become involved. This short discussion piece uses four case studies, drawn from English and Australian experiences, to highlight the relationship between tenure and housing risk. It also identifies the essential challenges that such cases pose and argues that it is time to increase public understanding of compulsive hoarding and to develop recognisable, predictable and holistic responses that address the issue as well as its impact.
The invisible man: a self-help guide for men with eating disorders, compulsive exercise and bigorexia
- Author:
- MORGAN John F.
- Publisher:
- Routledge
- Publication year:
- 2008
- Pagination:
- 172p.
- Place of publication:
- London
Increasingly boys and men are suffering with eating disorders and related body image problems. Some have full-blown conditions such as anorexia nervosa, bulimia, binge eating, compulsive exercising or bigorexia. Others are distressed by slightly lesser degrees of disordered eating or over-exercise and seek ways of overcoming their problems The Invisible Man applies the latest research to produce a practical, problem-focused self-help manual for men with eating disorders and body image problems
Cognitive risk factors to the development of anxiety and depressive disorders in adolescents
- Authors:
- DIA David A., BRADSHAW William
- Journal article citation:
- Child and Adolescent Social Work Journal, 25(6), December 2008, pp.469-481.
- Publisher:
- Springer
This exploratory study examines cognitive risk factors, anxiety sensitivity, and positive and negative affect, as related to the development of anxiety and depression. In a mailed survey in a region of the US, adolescents completed the Child Anxiety Sensitivity Index and the Positive and Negative Affectivity Scale. Previous research utilized the broad and unified variable of anxiety sensitivity as a predictor of anxiety. This study separates and examines the four specific factors of anxiety sensitivity: mental incapacitation concerns, social concerns, disease concerns, and unsteady concerns, and relates it to specific anxiety disorders and depression. Results indicate good convergent validity and improved divergent validity when utilizing the four factors of anxiety sensitivity as compared to using it as one construct. Results also suggest: (1) OCD and GAD share numerous similarities and (2) the importance of the role of negative affectivity in anxiety and depression. Being aware of the components of anxiety sensitivity and how they relate to specific anxiety disorders can help a social worker when rendering a diagnosis.
Compulsive hoarding: a qualitative investigation of partner and carer perspectives
- Authors:
- WILBRAM Mark, KELLETT Stephen, BEAIL Nigel
- Journal article citation:
- British Journal of Clinical Psychology, 47(1), March 2008, pp.59-73.
- Publisher:
- Wiley
This study explores the experiences of family members caring for a person who compulsively hoards. Ten participants, all `key carers' for a hoarding family member, were interviewed using a semi-structured interview schedule designed for the purpose of the study. Transcribed interviews were analysed using interpretive phenomenological analysis. Five superordinate, discrete but interconnecting themes were identified: `loss of normal family life'; `the need for understanding'; `coping with the situation'; `impact on relationships'; and `marginalization'. Carers' accommodation of hoarding behaviours and role isolation were examined in drawing connections between themes. Outlying themes suggesting factors protective of relationships and facilitating coping were also identified. Carers struggled to cope with both the environmental and interpersonal impacts of the hoarding. Lacking both formal and informal networks of support, carers are in need of information and treatment options for themselves and their families. Possible avenues for future clinical and theoretical research are suggested.
More than meets the eye: weight lifting and steroid use in men
- Authors:
- BARDICK Angela D., NIXON Gary, BERNES Kerry B.
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 8(2), 2008, pp.208-227.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study investigated men’s motivations for and experiences with attempting to achieve an ideal masculine body through heavy weight lifting, dieting and steroid use. The related literature is first reviewed then the results of the study in which 8 men living in southern Alberta, Canada were interviewed and asked to recount their experiences using a story format are reported. Subjects were aged from 21 to 35 years and were employed in a variety of occupations. Each subject reported that they had been lifting heavy weights 1 or more hours per day, 4 of more days per week, for a minimum of 6 months. Each had recognised that exercise may be interfering with their social life or work life. Four participants reported using steroids and four reported the use of non-steroid muscle building supplements. The nine main themes that emerged from the participants descriptions of their experiences were: I am not good enough; judging genetics; spiral into obsession; extreme commitment; join the club; no one understands me; control; it’s all an optical illusion; and desire to overcome the obsession. The authors comment that these themes suggest that men who attempt to achieve an ideal masculine body may become engaged in a cycle of obsessive-compulsive exercise, may be dealing with a variety of cognitive, behavioural, emotional, and social problems; and may attempt to overcome these problems by going to the gym rather than by seeking counselling. Implications for counselling are discussed including prevention, intervention and treatment.
How do hostile and emotionally overinvolved relatives view relationships?: what relatives' pronoun use tell us
- Authors:
- SIMMONS Rachel A., CHAMBLESS Dianne L., GORDON Peter C.
- Journal article citation:
- Family Process, 47(3), September 2008, pp.405-419.
- Publisher:
- Wiley
Expressed emotion (EE) has been linked to negative outcomes for a variety of psychiatric illnesses. Despite development of effective interventions to reduce EE, relatively little is known about EE's antecedents or maintaining factors. This American study uses a novel methodology (measurement of pronouns used by relatives during the Camberwell Family Interview [CFI] or a problem-solving interaction with the patient) to explore possible cognitive correlates of EE. Participants were 98 outpatients with obsessive-compulsive disorder or panic disorder with agoraphobia and their primary relative. Results showed that relatives' pronoun use was stable across situations. Relatives' hostility and criticism, as measured by objective coding of relatives' behaviour during the CFI and interactions, respectively, were related to relatives' decreased we-focus and increased me-focus in the 2 situations. In contrast to expectations, relatives' emotional over involvement was related to their decreased we-focus during CFIs and interactions. Results support the value of using pronouns as a means to explore important aspects of relationship functioning.