Psychological treatment of refractory obsessive-compulsive disorder and related problems
Salkovskis PM., Richards C., Forrester E.
© 2000 Lawrence Erlbaum Associates, Inc. Behavioral treatment of obsessive-compulsive disorder (OCD) has long been recognized as a highly effective approach to a previously intractable disorder. This type of psychological therapy has been found to be at least as effective as clomipramine, a selective serotonin reuptake inhibitor (SSRI) in the short term and is considerably better than this medication once medication is withdrawn (Kozak, Liebowitz, & Foa, chap. 25, this volume). Typically, cognitive-behavioral treatment programs report success rates of 75% or better (Abel, 1993; Abramowitz, 1996; Christensen, Hadzi-Pavlovic, Andrews, & Mattick, 1987; Stanley & Turner, 1995). Recent developments in drug treatment of OCD have resulted in newer, more selective SSRIs; however, the data may suggest that the more selective medication is to serotonin the less effective it is. Contrary to predictions from the reduced side-effect profile of the newer SSRIs, the data suggest that they do not decrease the dropout rate. Thus, even if the best interpretation is made of recent findings, development of pharmacological treatment of OCD has not resulted in an appreciable increase in treatment effectiveness. This is not to say that it is not useful to find better ways of blocking serotonin reuptake.