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23.8 Obsessive-Compulsive Disorder

Table of Contents

This condition is characterised by the presence of persistent intrusive thoughts or concerns, and is usually associated with compulsions, which are mental acts or behaviours which an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress i.e. excessive hand washing. Obsessive thoughts and compulsions may interfere with daily functioning. The features are usually distressing to the patient.

Diagnostic Criteria

  • A pattern of repetitive behaviours
  • Anxiety symptoms

Non Pharmacological Treatment

  • Psycho-education
  • Psychotherapy
  • Behaviour therapy

Pharmacological Treatment

S: Fluoxetine, oral. Initial dose: 20 mg. If there is no or partial response after 4–8 weeks, increase to 40 mg, if well tolerated.

OR

C: Citalopram, oral. Initial dose: 20 mg. If there is no or partial response after 4–8 weeks, increase to 40 mg, if well tolerated.

Referral

Refer to the next level in the following situations: Inadequate response to treatment

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