What are some treatment guidelines for OCD?
CPA 2006, NICE 2005, APA 2007, BMC Psychiatry 2014
The two main treatment options for OCD
CBT and SSRI medication.
Rate of placebo response in OCD
Percentage of patients who improve on medication
How do SSRIs compare to CBT?
CBT or CBT + medication does better
How does combined treatment compare to CBT alone?
Combination treatment is not better than CBT alone for moderately ill patients who are enrolled in RCTs.
Principles of treatment expectations for OCD
Cure and remission are not realistic expectations. Patients should expect to do homework and commit time to CBT.
Rate of response for behavioural treatment
Only 31% are NOT improved after behavioural treatment for OCD.
Components of CBT for OCD
Construct exposure hierarchy
Thought records / recognizing automatic thoughts
Identify and change cognitive distortions
Use of exercise for treatment of OCD
There were two positive studies in 2007. RCT underway as of 2016.
How might exercise help in OCD?
BDNF, effects on cerebral blood flow, increase hippocampal size?
Mindfulness or yoga for OCD?
Very little data; a handful of reports.
How much exercise is good for OCD?
At Thompson Centre they recommend 150 min / week of aerobic exercise.