PILOT STUDY EXAMINING THE POTENTIAL USE OF THE PSYCHOEDUCATION COMPONENT OF DANGER IDEATION REDUCTION THERAPY (DIRT) AS AN ADJUNCT TO TREATMENT FOR CONTAMINATION FEARS IN PATIENTS WITH PROFOUND REFRACTORY OBSESSIVE COMPULSIVE DISORDER

Abstract

Background The psychoeducational approach of Danger Ideation Reduction Therapy (DIRT) was developed and researched in Australia. There have been limited trials in other countries. Indeed, there are extremely few publications highlighting the use of DIRT outside Australia (Govender, Drummond and Menzies, 2006, Drummond and Kolb,). Methods All patients who had a contamination fears and who were inpatients at the time of the pilot study (5th May 2015 – 19 th May 2015) were asked to attend a series of 3 Psychoeducational Groups. The groups were weekly and covered the following topics: • Combined session of Statistics on contamination and HIV/AIDS • Immune system • Faeces and Vomitus These groups were prepared and delivered by the Ward-based junior doctor with the assistance of medical students attached to the Ward. All patients continued to receive appropriate psychopharmacological treatment as well as treatment involving Graded Exposure and self-imposed Response Prevention alongside those groups. At the end of the pilot patients were asked for their feedback. The qualitative data obtained from the patients were analyzed. Results Feedback from the participating patients revealed the following qualitative data: Provision of relevant, practical information on various health issues, relevant to people having OCD fears regarding possibility of catching various infection Provision of factual information was useful. It was an eye opener to know about the statistics and to realise how slim the chances of contamination are. Facts were provided in relation to the actual risks of acquiring various diseases rather than the risk/ fears in this regard or perceived by various OCD sufferers Understood about the digestive system, how it works, what faeces is made of (mainly water) Learnt that getting HIV off people is very rare. Acquired a good understanding about the natural defence mechanisms of the body. Discussion The study is small and is a pilot study. However it demonstrates that the Psychoeducational component of DIRT delivered in group format to a group of profound refractory OCD patients is generally well received and appreciated. Full studies need to continue to examine the efficacy of this approach. Summary The feedback of the pilot study has showed that it was well received and appreciated. Sample size being small and data being qualitative nature has been the two main limitations. A further study of a larger sample with more structured monitoring of progress in profound refractory OCD will be worth exploring.