Abstract
Aims and MethodA naturalistic study was conducted to examine the outcome on self-report and observer-rated measures in patients with severe, chronic, resistant obsessive–compulsive disorder (OCD) admitted to a specialised in-patient unit.ResultsTwenty-six patients were admitted over the study period. The mean age of all patients was 37 years (s.d.=13.8, range 18–61 years) and they had a mean duration of OCD of 18.4 years (s.d.=10.9, range 4–40 years). Instruments measuring severity demonstrated a 37–67% reduction in obsessive–compulsive symptoms and a 64% reduction in depressive symptoms after an average of almost 15 weeks in hospital.Clinical ImplicationsThis study demonstrates that specialised in-patient care can benefit a small group of severely ill patients with OCD who fail to respond to treatment in primary and secondary care.
Highlights
Twenty-six patients were admitted over the study period.The mean age of all patients was 37 years (s.d.=13.8, range 18-61 years) and they had a mean duration of obsessive-compulsive disorder (OCD) of 18.4 years (s.d.=10.9, range 4 - 40 years)
This study demonstrates that specialised in-patient care can benefit a small group of severely ill patients with OCD who fail to respond to treatment in primary and secondary care
On admission there were no significant differences in either severity of depression or OCD between these 13 patients who failed to complete the measures at discharge and those who did
Summary
Twenty-six patients were admitted over the study period.The mean age of all patients was 37 years (s.d.=13.8, range 18-61 years) and they had a mean duration of OCD of 18.4 years (s.d.=10.9, range 4 - 40 years). Guidelines on the treatment of obsessive ^ compulsive disorder (OCD) from the National Institute for Health and Clinical Excellence propose a six-stage model of stepped care, with patients with the most severe and resistant problems being treated as in-patients using psychological and drug treatments or other intensive treatment programmes (National Institute for Health and Clinical Excellence, 2006). There is only one fully staffed National Health Service in-patient unit in England that treats patients with severe OCD using predominantly psychological methods and another in Scotland that specialises in neurosurgical techniques. This dearth of services is not surprising since only about 1% of the population have clinically relevant OCD (Karno et al, 1988). We report a naturalistic cohort study of recent treatment in our unit
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