Over på behaviortherapist.com har de et interview med dr. Jonathan Abramowitz om obsessiv-kompulsiv tilstand. Han fortæller bl.a. om:

* Hvad er Obsessiv-Compulsiv Disoder (OCD)? (På dansk tvangstanker og tvangshandlinger.)

* Almindelige former for OCD, herunder fælles kategorier for obsessioner – OCD er ikke altid frygt for bakterier og at vaske af hænder!

* Forskellige former for behandling af OCD og deres relative effektivitet.

* Hvad er Exposure and Response Prevention (ERP) – det er ikke så slemt som det lyder! Abramowitz giver en fremragende gennemgang af baggrunden for og formålet med ERP og hvordan behandlingen udføres.

* Tilgængelige ressourcer for OCD-ramte og deres familier. (mest relevant for folk bosiddende i US)

* Og meget mere!

Interviewet giver et godt overblik over OCD og behandling af OCD, og kan hermed anbefales.

Lyt til interviewet: Obsessive-Compulsive Disorder på Behaviortherapist.com

Hat tip: Psychotherapy Brown Bag

Jonathan S. Abramowitz har skrevet 10 bøger og omkring 100 peer review artikler. Den seneste bog er: Getting over OCD, – A 10-Step Workbook for Taking Back Your Life.

Lidt om bogen:
Just imagine: No more obsessional thoughts and compulsive behaviors. No more planning your day around avoiding certain situations. You can get over OCD—and join the thousands of people who are living freer, happier lives thanks to the clinically proven strategies in this book. Noted OCD specialist Dr. Jonathan Abramowitz provides the information, support, and practical tools you need to:

*Understand your obsessions, compulsions, and rituals
*Develop a customized action plan
*Take gradual steps to safely confront—and master—the situations you avoid
*Find relief from intrusive thoughts, no matter how distressing
*Overcome compulsion urges
*Reduce anxiety and improve your relationships

Based on cognitive-behavioral therapy, the most effective treatment for OCD, the workbook’s carefully sequenced exercises are illustrated with detailed examples.

Bogen kan købes hos saxo.com:
Forfatter: Jonathan S. Abramowitz
Getting over OCD, – A 10-Step Workbook for Taking Back Your Life.
Forlag: Guilford Press 2009, 307 sider.

Biografi:
Jonathan S. Abramowitz, PhD, is Professor of Psychology and Director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. Before moving to North Carolina, Dr. Abramowitz founded and directed the OCD and Anxiety Disorders Program at the Mayo Clinic in Rochester, Minnesota. His award-winning research on OCD has been supported by the National Institute of Mental Health, among others, and he serves on the Scientific Advisory Board of the Obsessive Compulsive Foundation. He lives in Chapel Hill with his wife and two daughters.

David Beckham revealed the extent of his obsessive compulsive disorder (OCD) on the last episode of Parkinson.

In the finale of the host’s enduring chat show, the former England captain said:

“In our house in Spain we used to have this big rug that when you hoovered it, you could do it in lines like Wembley.”

“Victoria used to catch me after the kids had gone to bed doing the hoovering and it would all be in perfect lines.”

Beckham on the last Parkinson Show:

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Broadcasted 17th. december 2007

It’s a Brain thing: OCD

Learn about obsessive/compulsive disorder. Some interesting data about the physical changes both psychotherapy and medications make on PET scans in folks with OCD.

The “It’s a Brain Thing” video series was developed by psychiatrist David Henley, M.D.

It’s a Brain thing: OCD (Part 1 of 3)

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It’s a Brain thing: OCD (Part 2 of 3)

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It’s a Brain thing: OCD (Part 3 of 3)

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MIMHCE The Missouri Institute of Mental Health (MIMH) is an educational research branch of the University of Missouri-Columbia School of Medicine. The Institute’s Continuing Education Division (CE), established in 1980, has a mission to develop and deliver high quality training programs and materials for mental health professionals throughout the state, region, and nation, with a special emphasis on the needs of public sector mental health professionals in Missouri.

OCD: A Clinical Intervention

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In this video, Mr. Mitchell describes Obsessive Compulsive Disorder and identifies the criteria for its diagnosis. In addition, Mr. Mitchell describes how OCD is manifested in behavior and identifies treatment options for the disorder. Further discussion centers on how family and other support systems are affected by the person with OCD.

OCD: A Client’s Perspective

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In this video Ms. Amanda Tarter discusses her symptoms as related to her diagnosis of OCD. She further describes coping strategies that help diminish the impact of OCD symptoms and identifies accommodations that have proven helpful for her as a student in college.

OCD: A Families Perspective

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The content of this program focuses the presenter’s personal experience of identifying and utilizing systems of support for his son who was diagnosed with OCD at an early age.

Cartoons

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A very sweet cartoon about a mouse suffering OCD. Created by a CalArts student.

OCD suffers trying to explain what OCD is like

Obsessive Compulsive Disorder Presentation

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This was created to demonstrate what Obsessive Compulsive Disorder can look like. This was a project for my nursing class, however, it is a serious life altering disorder, and needs to be taken seriously.

Short film

The Meaning of 3

The Meaning of 3 is a serious farce about Martin who suffers from Obsessive Compulsive Disorder, he can’t help it but he just has to repeat actions 3 times over. Martin wakes to a normal day but what occurs takes Martin on a journey that will change his life forever…

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Forskere har fundet frem til at et protein sandsynligvis spiller en væsentlig rolle ved Obsessive Compulsive Disorder.

Det ser ud til, at der er en dysfunktion i det cortico-striato-thalamo-cortical kredsløb, der også har indflydelse på OCD. Proteinet SAPAP3, også kendt som DLGAP3, er et protein, der findes i striatum, hvor det er vigtigt for at signaler kan sendes over synapsekløften, altså at nerverne kan ‘snakke’ sammen. Striatum er et område i hjernen, der håndtere planlægningen og udførelsen af bevægelser samt andre kognitive funktioner – et område i hjernen, der er en vigtig ‘beslutningstager’.

I forsøget hvor man anvendte mus, fjernede man SAPAP3 proteinet fra musene, hvilket medførte at musene havde en adfærd, der mindede meget om OCD, fordider var defekter i synapserne. Når man gav musene SAPAP3 proteinet igen, blev deres OCD adfærd reduceret, fordi synapserne blev repareret. Endvidere så man at SSRI præparater reducerede musenes OCD og angstniveau.

Kilde:

Cortico-striatal synaptic defects and OCD-like behaviours in Sapap3-mutant mice, Nature 448, 894-900 (23 August 2007)

Mice provide important clues to obsessive-compulsive disorder, EurekAlert! Public release date: 22-Aug-2007

Mice Provide Important Clues to Obsessive-Compulsive Disorder, Duke University Medical Center, Published: 08/23/2007

A senior lecturer at Tel Aviv University, Dr. Dannon is known worldwide for work in the area of gambling and addiction, a major research focus for him since 1995. His first article on kleptomania was published in 1996. He will present his new research findings on addiction at the National Gambling Council’s meeting in Las Vegas this November.

Is your first craving in the morning for your computer mouse? Do you obsessively check email in the middle of the night?

If so, you may be among the ten percent of all Internet surfers afflicted with “Internet addiction disorder,” a pathological condition that can lead to anxiety and severe depression. To better diagnose and treat Internet addiction, Dr. Pinhas Dannon, a psychiatrist from Tel Aviv University’s Sackler Faculty of Medicine, recommends that it be grouped with other extreme addictive disorders such as gambling, sex addiction, and kleptomania.

A senior lecturer at Tel Aviv University, Dr. Dannon is known worldwide for work in the area of gambling and addiction, a major research focus for him since 1995. His first article on kleptomania was published in 1996. He will present his new research findings on addiction at the National Gambling Council’s meeting in Las Vegas this November.

Internet addiction is currently classified by mental health professionals as an Obsessive Compulsive Disorder ( OCD ), a mild to severe mental health condition that results in an urge to engage in ritualistic thoughts and behavior, such as excessive handwashing or, in the case of the Internet, Web surfing.

“But we are saying that we need to look at Internet addiction differently,” reports Dr. Dannon on behalf of his colleagues from Tel Aviv University and the Be’er Ya’acov Mental Health Center. “Internet addiction is not manifesting itself as an ‘urge.’ It’s more than that. It’s a deep ‘craving.’ And if we don’t make the change in the way we classify Internet addiction, we won’t be able to treat it in the proper way.”

Two groups are at greatest risk from Internet addiction disorder, Dr. Dannon warns. The first are teenagers. But more surprisingly, the second are women and men in their mid-50s suffering from the loneliness of an “empty nest.” The symptoms of Internet addiction in both groups are vague and are often difficult to diagnose. Sufferers may experience loss of sleep, anxiety when not online, isolation from family and peer groups, loss of work, and periods of deep depression.

Treating Internet addiction can only be done effectively, believes Dr. Dannon, if the condition is treated like any other extreme and menacing addiction. For example, a clinician could use talk therapy or prescribe medication such as Serotonin blockers and Naltrexone, which are also effective against kleptomania and pathological gambling. No less important, Dr. Dannon stresses, is that mental health practitioners in schools and workplaces should be made aware of the risks of Internet addiction. Workshops on these risks should be held in both milieus, he advises.

Dr. Dannon and his colleagues have recently reported their findings in the Journal of Clinical Psychopharmacology; and have since waged a mini-campaign around the world to warn doctors about the dangers associated with excessive Internet use. Their research on gambling addiction has been used to educate American doctors taking the annual “Continuing Medical Education” test taken before the doctors can renew a license to practice medicine.

According to Dr. Dannon, Internet addicts are inevitable and a product of modernization.

“They are just like anyone else who is addicted to coffee, exercise, or talking on their cellular phone. As the times change, so do our addictions.”

In a study of brain imaging using MR scan it was found that its possible to identify with 93% accuracy rate patients that have OCD over those that don’t by looking at the whole brain image.

From abstract:

Structural neuroimaging studies have reported a variety of brain alterations between groups of obsessive-compulsive disorder (OCD) patients and healthy controls. However, the large heterogeneity in discrete anatomical measures that exists among patients prevents a clear discrimination of single patients from healthy subjects. This reduces the potential clinical applicability of structural neuroimaging studies. In the present study we assessed the feasibility of identifying OCD patients on the basis of whole-brain anatomical alterations. Whole-brain magnetic resonance images were collected from two consecutive samples of OCD outpatients (n=72 and n=30), and control subjects (n=72 and n=30). We computed the whole-brain (voxel-wise) pattern of structural difference between OCD patients and control subjects at the group level. A single expression value of this difference pattern was calculated for each subject, expressing their degree of ‘OCD-like’ anatomical alteration. Accuracy of patient classification based on these expression values was assessed using two validation approaches. Firstly, using a cross-validation method, we obtained a high classification accuracy (average of the sensitivity and specificity indices) of 93.1%. In a second assessment, which classified new groups of OCD patients and control subjects, overall accuracy was lower at 76.6%. Individual expression values for OCD patients were significantly correlated with overall symptom severity as measured by the Y-BOCS scale. Our results suggest that OCD patients can be identified on the basis of whole-brain structural alterations, although the accuracy of our approach may be limited by the inherent variability of psychiatric populations. Nevertheless, the anatomical characterization of individual patients may ultimately provide the psychiatrist with relevant biological information.

Identifying patients with obsessive-compulsive disorder using whole-brain anatomy, NeuroImage, Volume 35, Issue 3 , 15 April 2007, Pages 1028-1037 Hat Tip: Brainethics

At the ADAA 27th Annual Conference 2007 (ADAA is The Anxiety Disorders Association of America) two completed research programs for Obsessive-Compulsive Disorder treatment were presented:

Intensive Cognitive Behavioural Treatment Has Slight Edge as OCD Treatment: Presented at ADAA
While both intensive and weekly cognitive-behavioural treatment (CBT) eventually provide similar extent of improvement for obsessive-compulsive disorder (OCD), intensive treatment may be "somewhat more expedient," researchers reported here at the 27th Annual Meeting of the Anxiety Disorders Association of America (ADAA). Eric A. Storch, PhD, assistant professor, departments of psychiatry and paediatrics, University of Florida, Gainesville, Florida, United States, and associates randomised 40 children and adolescents with OCD to weekly or intensive CBT. "Cognitive-behavioural treatment with exposure and response prevention alone or with concurrent pharmacotherapy is the first-line therapy for OCD," Dr. Storch said in his presentation on March 31st. "However, a primary limitation remains access to practitioners since most research on CBT has been done in specialised academic centres rather than in routine clinical settings. Thus, patient access to treatment is limited by the availability of trained therapists, and most patients receive no treatment, medication alone, and/or non-CBT psychotherapy." A potential solution, he added, is intensive CBT.

Kilde: Doctors Guide Read article

Teens With Severe OCD Can Be Successfully Treated as Inpatients: Presented at ADAA
Investigators reported early favourable results using an intensive inpatient programme to treat adolescents with obsessive-compulsive disorder (OCD) who failed conventional outpatient treatment. "Our data show that inpatient treatment for OCD in an adolescent population is very effective in reducing symptom severity," said senior investigator Throstur Bjorgvinsson, PhD, program director, Obsessive-Compulsive Disorder Treatment Program, Menninger Clinic, Houston, Texas, United States, said at the 27th Annual Meeting of the Anxiety Disorders Association of America (ADAA). "In addition, we found a reduction in the strength of belief in constructs hypothesised to be important in the maintenance of this disorder," he said during a presentation on March 31st.

Kilde: Doctors Guide Read article

Der er blevet udgivet tre online videoer om OCD. Videoerne er produceret af Missouri Institute of Mental Health. Missouri Institute of Mental Health anvender bl.a. videoer til at informere befolkningen om forskellige sygdomme og for at uddanne de personer, der lider af en specifik sygdom, i deres sygdom (psykoedukation). Programmet varetages af Continuing Education Television, web-based learning, (CE TV). Programmerne er meget informative og kan anbefales til inspiration til dansk sundhedsinformation og behandling.

OCD: A Clinical Intervention

In this video, Mr. Mitchell describes Obsessive Compulsive Disorder and identifies the criteria for its diagnosis. In addition, Mr. Mitchell describes how OCD is manifested in behavior and identifies treatment options for the disorder. Further discussion centers on how family and other support systems are affected by the person with OCD.

OCD: A Client’s Perspective

In this video Ms. Amanda Tarter discusses her symptoms as related to her diagnosis of OCD. She further describes coping strategies that help diminish the impact of OCD symptoms and identifies accommodations that have proven helpful for her as a student in college.

OCD: A Families Perspective

The content of this program focuses the presenter’s personal experience of identifying and utilizing systems of support for his son who was diagnosed with OCD at an early age.

BBC World har skrevet en artikel om et forsøg med at anvende psilocybin i behandling af OCD. Der har været en del kritik af at man ikke har gjort forsøget double-blind, så man kunne teste forsøget for placebo effekt. En del af forsøgspersonerne havde en positiv effekt af behandling. Det er 30 år siden man sidst har testet psilocybin i kliniske forsøg.

The need for more treatment options and anecdotal reports of OCD patients undergoing periods of remission after using hallucinogens led Moreno and colleagues to give psilocybin to nine people who had had not responded to other treatments. The patients did see a significant reduction in symptoms for up to 24 hours after they were given psilocybin even on the lowest dose. But because there was no group given a different drug or no drug at all to compare them to, the benefits could have been simply due to care and attention from the researchers.

Kilde: Psychedelic drug ‘hope for OCD’, BBC, 11 december 2006 Se desuden: Purpose and objectives of the study: Effects of Psilocybin in Obsessive-Compulsive Disorder, Principal Investigators: Francisco A. Moreno, MD, Pedro Delgado, MD, Alan J. Gelenberg, MD; University of Arizona The Journal of Clinical Psychiatry: Safety, Tolerability, and Efficacy of Psilocybin in 9 Patients With Obsessive-Compulsive Disorder. Francisco A. Moreno, Christopher B. Wiegand, E. Keolani Taitano, and Pedro L. Delgado; vol 67, 2006, no 11, p. 1735

I Danmark er det som bekendt ikke muligt at få hjælp til kognitiv adfærdsterapi hos en psykolog. I stedet har man fra politisk side valgt at opretholde brugerbetaling på dette område, dog har der på det sidste vist sig et muligt kursskifte efter at de konservative har skiftet standpunkt (det er lidt uklart om deres udspild vil indeholde psykologhjælp til psykisk syge børn og voksne). Venstre er dog stadig i mod (Se denne artikel), og spørgsmålet er om de konservative kan få overtalt finansministeren?

Et argument kunne være at se på om kognitiv adfærdsterapi overhovedet virker. Det ansete Cochrane Collaboration, der undersøger evidensbaseret behandling i hele verden, har publiceret en undersøgelse, hvor de gennegår forskellige undersøgelser for at se om en behandling virker. Forfatterne kom frem til følgende konklusion:

Although only based on a small number of studies, behavioural or cognitive-behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.

Kilde: O’Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004856. DOI: 10.1002/14651858.CD004856.pub2. This version first published online: 18 October 2006 in Issue 4, 2006 Date of Most Recent Substantive Amendment: 22 August 2006 (Hvis du bor i Danmark har du adgang til Cochrane) Et andet væsentligt punkt er at det har vist sig at man i stedet for at henvise til kognitiv adfærdsterapi i stedet udskriver medicin i behandlingen af OCD, selvom kognitiv adfærdsterapi er mere effektiv sammen med medicin end medicin alene.

Carol A. Mathews, M.D., with the department of psychiatry at the University of California, San Francisco, called the systematic review ‘excellent’ and said it represents an important step forward in the understanding of the effectiveness of various types of treatment for pediatric OCD. Pediatric OCD is frequently underdiagnosed and undertreated, she said, and this could be because of limited treatment options parents have for their children. This study shows convincingly that CBT is superior to placebo, not only in reducing the number of OCD symptoms, but also in effecting remission in many cases. The study also shows that CBT plus medication is more effective than medication alone in children ‘an important confirmation of what has been believed clinically, but never proven,’ said Mathews, who was not involved with the study. ‘The results of this paper provide clinicians and parents with an additional effective treatment option – CBT or CBT plus medication – a treatment that involves only about 14 to 21 hours, in general,’ Mathews said. ‘Probably the most important issue related to our findings is that while the evidence suggests that CBT is as effective as medication, relatively few children and adolescents get CBT treatment,’ O’Kearney said. ‘Part of this is because of access and part is because primary care doctors often prescribe medicine before they refer patients to CBT. Hopefully this review will make them think more about this practice.’

Kilde: Newswise 15. oktober 2006 Se også: Medical News Today