Though pharmacological and/or behavioral interventions have proven highly effective, 20 to 30% of the obsessive-compulsive disorder (OCD) population is treatment refractory. This study describes the OCD clinical profile that is correlated to organicity. Two groups of OCD patients were presented: an organic group and a control nonorganic group. The 9 organic patients exhibit an indifference to their illness, a lack of motivation, are nonanxious even during exposure exercises, are nondepressed, have rigid and concrete thinking, are treatment refractory, and have some type of organic impairment. The 10 nonorganic patients are also treatment refractory but do not exhibit the clinical profile correlated to the organic OCD patients. Furthermore, MRI results indicate that no organic impairment exists in this control group. All of these patients were tried on medication and behavior therapy to no avail. Reasons for lack of response in organic OCD patients, based on cerebral anatomical changes, are discussed.
AbstractSummary: Objective: The authors sought to determine the long-term outcome of patients with severe and refractory obsessive-compulsive disorder spectrum (OCDS) following neurosurgery.Method: Five patients who underwent neurosurgery as a last-resort treatment for refractory OCDS were evaluated. On all patients, posttest data was obtained from the Yale-Brown Obsessive-Compulsive Scale, The Overvalued Ideas Scale, the Beck Depression Inventory and the Beck Anxiety Inventory. Pretest scores were available on three patients as well.Results: All patients failed to maintain initial improvements after surgery and relapsed. In addition, they became depressed with suicidal ideation or attempt.Conclusion: Complications of neurosurgery are discussed, notably relapse and depression.Key Words: OCDneurosurgerydepressionsuicidalityrelapse.
1. The Full-Time Companion 2. The Turning Point 3. Journey to the Unknown 4. Partnerships 5. A Bird's-eye View 6. The Behavioral Approach 7. The Biological Approach 8. In-patient versus Out-patient Treatment 9. The Social Sense 10. The Family 11. The Road to Freedom 12. Comorbidiby Epilogue: 100 Questions Appendix A: Social Readjustment Rating Scale Appendix B: Guidelines for Families Coping with Obsessive-Compulsive Disorder.
