The article by Fineberg et al. (2020) presents therapeutic advances judged to be most relevant to treating OCD, based on evidence from clinical science and clinical practice. They discuss the importance of early intervention in treating OCD.
Today, OCD is recognized as a common yet disabling but treatable mental illness.
OCD is the head of a family of obsessive-compulsive spectrum disorders, which include related disorders, such as body dysmorphia, hoarding, hair-pulling, skin picking and olfactory reference disorders and hypochondriasis, “all sharing compulsive behaviour as a cardinal characteristic” (Fineberg et al., 2020). Serotonin reuptake inhibitors and cognitive behavioural therapy (CBT) that involve exposure to triggers and focused response prevention are the main treatment options used to combat OCD; research suggests that earlier intervention results in better outcomes.
Clinical advances suggest that cognitive behavioural therapy, selective serotonin reuptake inhibitor or both is the best option for treating OCD. CBT and SSRIs should be considered first for treatment of OCD.
For those resistant to treatment, noninvasive neuromodulatory interventions hold significant promise. This approach targets the corticostriatal thalamocortical circuits and may be helpful for treatment-resistant OCD.
Some patients do not respond to therapies that are available to them, and unfortunately suffer from severe OCD symptoms (Fineberg et al., 2020)). For these patients, ablative neurosurgery and deep brain stimulation may be considered. Deep brain stimulation is still an experimental treatment, but is still an option for severe treatment-resistant OCD.
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