Treatment outlines for the management of obsessive-compulsive disorders. The Quality Assurance Project

Abstract

The Quality Assurance Project is developing explicit and detailed treatment outlines for each of the major psychiatric disorders. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists, and the views of a panel of nominated experts. The recommendations for the treatment of obsessive-compulsive disorder were as follows: for those patients who have no significant personality disorder, either short-term dynamic psychotherapy or cognitive behaviour therapy is indicated if the illness has lasted less than a year or if obsessions are the predominant symptoms. When compulsions predominate, particularly when they have been present for more than a year, response prevention is the treatment of choice. Tricyclic antidepressants and cingulo-tractomy are also worthy of consideration in patients with persisting symptoms. Psychotherapy or cognitive behaviour therapy are the approaches recommended for compulsive personality disorder.