The Efficacy of Exposure and Response Prevention for Geriatric Obsessive Compulsive Disorder: A Clinical Case Illustration

Mairwen K Jones,Lisa D Vaccaro,Bethany M Wootton

doi:10.1155/2012/394603

Mairwen K Jones, Lisa D Vaccaro + Show 1 more

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https://doi.org/10.1155/2012/394603

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Abstract

Obsessive compulsive disorder (OCD) is one of the most frequently occurring psychiatric conditions in older adults. While exposure and response prevention (ERP) is considered the most effective psychological treatment for children and adults with OCD, research investigating its effectiveness for older adults is scarce. This clinical case study investigates the effectiveness of ERP in an 80-year-old man with a 65-year history of OCD. The client received 14 individual, 50-minute ERP treatment sessions. Clinician-based Y-BOCS scores reduced by 65% from 20 (moderate) at pretreatment to 7 (subclinical) at 7-month posttreatment followup. OCI-R total scores reduced by 45% from 38 at baseline to 21 at 7-month follow-up. Despite his long history of the disorder, ERP was effective and well tolerated. The application of ERP for older adults with OCD, including age-specific modifications that may be required for this treatment approach, is discussed.

Highlights

Obsessive compulsive disorder (OCD) is an anxiety disorder characterised by intrusive obsessions and/or repetitive, timeconsuming compulsions [1]
While research investigating response to exposure and response prevention (ERP) treatment in elderly clients with OCD is extremely scarce, the findings presented above demonstrate that this approach is very effective for some elderly people with OCD
Yale Brown Obsessive Compulsive Disorder Scale (Y-BOCS) data were collected at baseline and 7-month posttreatment

Summary

Introduction

Obsessive compulsive disorder (OCD) is an anxiety disorder characterised by intrusive obsessions and/or repetitive, timeconsuming compulsions [1]. It is a disabling condition with significant impairment in functioning [2] and a high burden of disease and injury [3]. A considerable number of older adults are likely to be living with OCD [6], since they may have had the condition for many years and either not sought treatment or received inappropriate or ineffective treatments in the past [4]. Grenier et al [7] classified 1.5% of a sample of 2798 community dwelling adults aged over 65 years as probable OCD cases. It has been argued that OCD is likely to be one of the most frequently occurring psychiatric conditions in this age group [10]

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