Obsessive-compulsive disorder (OCD), which can cause significant impairment in personal, social, and academic contexts, affects nearly half a million children in the United States. Standards of medical care are determined on the basis of all clinical data available for an individual patient and are subject to change as scientific knowledge and technology advance and practice patterns evolve. The treatment trial should be continued at this dosage for a minimum of six weeks. PMID: 17849776 No abstract available. Patients with … After this time, patients may taper the dosage by 10 to 25 percent every one to two months while watching for the return or exacerbation of symptoms. APA released a new practice guideline on the treatment of alcohol use disorder. The heterogeneity of the population and the complexity of the disorder have been contributing factors. An executive summary of the guideline is published in the American Journal of Psychiatry, available online today. An SSRI alone is recommended for patients who have previously responded well to a given drug or who are unable to cooperate with CBT. In Obsessive–Compulsive Disorder, Dr. R. Reid Wilson demonstrates and discusses his cognitive–behavioral approach to treating obsessive–compulsive disorder (OCD).OCD is a common anxiety disorder that involves obsessive thinking accompanied by compulsive behavior. The Annex starts off by defining the different types of APA and outlines the objectives of the APA process. If the SSRI is augmented with clomipramine, the physician should use precautions to prevent cardiac and central nervous system side effects. Other options include switching to venlafaxine (Effexor), although it is less likely to produce an adequate response, or switching to mirtazapine (Remeron). Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). When the initial treatment is unsatisfactory, several factors may be contributing to the lack of improvement: interference by concomitant conditions, inadequate patient adherence to the treatment plan, the presence of psychosocial stressors, the family's degree of accommodation for the patient's symptoms, and the patient's inability to tolerate psychotherapy or medication. Patients who are severely resistant to treatment may benefit from intensive residential treatment or partial hospitalization. In 2007, the American Psychiatric Association (APA) published treatment recommendations for obsessive-compulsive disorder (OCD). Copyright © 2020 American Academy of Family Physicians. “Treating Obsessive-Compulsive Disorder: A Quick Reference Guide” is a synop- sis of the American Psychiatric Association’s Practice Guideline for the Treatment of Patients With Obsessive-Compulsive Disorder, which was originally published in The American Journal of Psychiatry in July 2007 and is available through American Psychiatric Publishing, Inc. For this reason, discontinuing pharmacotherapy should be carefully considered. Dynamic psychotherapy or psychoanalysis has not been shown to be effective in addressing the core symptoms of OCD. The American Psychiatric Association (APA) is committed to ensuring accessibility of its website to people with disabilities. Group or individual formats should be … If the patient's response to the treatment is inadequate, trial data suggest that higher SSRI dosages produce a somewhat higher response rate and greater relief of symptoms. Want to use this article elsewhere? Dr. Wilson's approach is to focus closely on a client's thought processes so as to make the client realize the … If an interfering factor cannot be identified for patients who have only a partial response, the physician should consider augmenting current strategies rather than switching strategies. The guideline appears in 3 distinct sections: treatment recommendations; background information and review of available evidence; and future research needs. The physician should discuss the risks and benefits with the patient. If the patient lacks motivation to pursue further treatment despite limited improvement, the physician should address issues of depression and secondary gains of the illness. The adopted APA guideline is one of the most comprehensive and widely used evidence-based clinical practice guidelines for this disorder, incorporating developments in pharmacotherapy and other areas of psychiatric management of individuals with OCD. Treatment adherence may be enhanced through education about the disorder and its treatments. For patients who take a higher dosage, it is important to monitor for side effects, including the serotonin syndrome. It therefore has the same status as the existing eight Chapters of the Guidelines. 78/No. When beginning a treatment for OCD, the physician should consider the patient's motivation and ability to comply with pharmacotherapy and psychotherapy. oping this guideline. dose) Fluoxetine 20-60 mg Fluvoxamine 50-300 mg Paroxetine 20 to 60 mg APA also thanks the APA Steering Committee on Practice Guidelines (Michael Vergare, M.D., Chair), liaisons from the APA Assembly for their input and assistance, and APA Councils and others for providing feed-back during the comment period. The patient's developmental, psychosocial, and socio-cultural history should be documented, as well as how the OCD has affected the patient's familial, social, and sexual relationships. 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