Rogers Memorial Hospital (Wisconsin).

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Rogers Memorial Hospital (Wisconsin)."

Transcription

1 Bradley C. Riemann, Ph.D. Clinical Director, OCD Center and CBT Services Rogers Memorial Hospital The Use of Exposure and Ritual Prevention with OCD: Key Concepts and New Directions OCD Center Rogers Memorial Hospital (Wisconsin). Child & Adolescent IOP. Adult IOP. Adult PHP. Child Residential. Adolescent Residential. Adult Residential. Comorbid Residential (OCD and ED). 1

2 Brad Riemann Director of OCD Center. Chair, Clinical Advisory Committee of the International Obsessive Compulsive Disorder Foundation (IOCDF). Member, Scientific Advisory Board of IOCDF. Member, Clinical Advisory Board of Anxiety and Depression Association of America. Introduction Brief overview of obsessive-compulsive disorder (OCD). Signs and symptoms. Common associated features. Yale-Brown Obsessive-Compulsive Scale. Components of exposure and ritual prevention (ERP) for OCD. Keys to successful exposure therapy. New directions. 2

3 OCD DSM-V has reclassify under new grouping of Anxiety and Obsessive-Compulsive Spectrum Disorders. Body Dysmorphic Disorder. Hair-pulling Disorder. Characterized by either obsessions or compulsions. Obsessions Recurrent, and persistent thoughts, urges, or images that are experienced as intrusive and unwanted and cause marked anxiety or distress. Person attempts suppress obsessions or to neutralize them with some other thought or action (i.e., compulsion). 3

4 Common Obsessions Contamination (1). Repeated doubt (2). Need for exactness or symmetry. Need to tell, ask or confess. Harming. Sexual imagery. Religious. Compulsions Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied (i.e., ritual). Behaviors or mental acts are aimed at preventing or reducing anxiety or distress or preventing some dreaded event. 4

5 Common Compulsions Checking (1). Washing or cleaning (2). Counting. Ordering. Repeating. Praying. Reassurance Seeking. Commonly Asked Questions How common is OCD? 2.5% of population life-time prevalence. 4 th most common psychiatric condition in U.S. Sex differences? No. Males do seem to develop earlier however. Onset? Average age is 20.2 years. Roughly half by 18 years of age. Rarely after 50 years of age. 5

6 Associated Features Secondary depressed mood (85%). Low self-esteem and social withdrawal. Academic and occupational impairment. Family discord. Fear embarrassment (hide symptoms). Avoidance. Leading Causes of Disability (WHO) 1. Major Depression. 2. Iron-deficiency anemia. 3. Falls. 4. Alcohol use. 5. Chronic obstructive pulmonary disease. 6. Bipolar disorder. 7. Congenital anomalies. 8. Osteoarthritis. 9. Schizophrenia. 10. OCD. 6

7 Assessment Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; Goodman et al., 1989). 60 symptom checklist (past and current). Self-report version. Childhood version (CY-BOCS). 10 item severity rating scale (0-4). 5 questions regarding obsessions. 5 questions regarding compulsions. Mean score for OCD = 24. Y-BOCS 0-7 = subclinical = mild = moderate (16 trial cut-off) = severe = extreme. 7

8 ERP for OCD Key element to effective treatment for OCD. Meyer (1966). Based on the principle of habituation. Habituation is the decrease in anxiety experienced with nothing but the passage of time. Exposure and the Keys to Success Exposure is placing an individual in feared situations (targets the obsessions). Needs to be prolonged enough to lead to within trial habituation (at least 50% reduction in anxiety). 8

9 Within Trial Habituation Fear level Time Keys to Exposure Needs to be repetitive enough to lead to between trial habituation (until causes minimal to no anxiety). Treatment effect. 9

10 Between Trial Habituation Time (mins) Session 1 Session 2 Session 3 Session 4 Keys to Exposure Needs to be graduated (increases compliance). Compliance with doing the exposures. Compliance with doing the ritual prevention. 10

11 Ritual Prevention Ritual Prevention is blocking the typical response or ritual before, during, and after exposure so habituation can take place (targets compulsions). Replace the ritual with habituation as way of controlling anxiety. Exposure Hierarchy Development Y-BOCS symptom checklist and severity rating scales. Generate specific exposure exercises. Patient rates each exercise on scale of 0-7 on perceived difficulty. Create exposure hierarchy. 11

12 Sample of Exercises 3 S Touch bedroom door knob and don t wash. Turn on stove and turn off and don t check. Rotate couch pillow 15 degrees to left don t fix. Drive past high school at 9:30 a.m. don t drive around block to check. Outcomes American Psychiatric Association (2007) recognized ERP, SRI, or a combination as evidenced-based treatments for OCD. Foa et al. (1996) meta-analysis of 12 ERP studies with 330 patients. 83% much or very much improved. 12

13 Outcomes Greist et al. (1996) compared 18 studies with 294 patients. Average decrease in YBOCS of 11.8 with ERP (SRI s=7.5). Foa et al (2005) multi-site study found: CMI < ERP = ERP+CMI. ERP also effective for pediatric OCD (e.g., POTS Team, 2004). Outcomes, con t Low relapse rates with ERP. Foa (1996) 16 studies with 376 patients found 76% much or very much improved at follow-up (average 2.5 years). 13

14 Advantages of ERP Effective and robust. Only side effect is increased anxiety during treatment (can manage by conducting graduated exposure). Quick improvements (many after first week of treatment). Disadvantages of ERP Hard work. Noncompliance. Absence of ERP. Quality of ERP when available. 14

15 New Directions Attention Retraining. Those with anxiety disorders have been found to exhibit an attention bias for disorder specific threat cues. Computer program trains individuals to redirect their attention away from threat onto neutral cues thus correcting attention basis. Leads to significant symptom reductions. Attention Retraining 6 randomized controlled trials. Stand-alone treatment for generalized anxiety disorder, social anxiety disorder and chronic pain. CBT enhancement for OCD. Riemann, Kuckertz, Rozenman, Weersing & Amir (2013). Enhanced outcome for OCD, social anxiety, and depression vs. placebo. 15

16 Summary OCD is a common and debilitating condition. Key element of effective treatment is ERP. Keys to effective exposure therapy include prolonged, repetitive and graduated exposure. Attention retraining may also prove to be effective in treating OCD stand-alone or as an augmentation to ERP. 16

Eating Disorders and OCD: A Clinical Perspective Theodore E. Weltzin, MD, FAED, FAPA

Eating Disorders and OCD: A Clinical Perspective Theodore E. Weltzin, MD, FAED, FAPA Eating Disorders and OCD: A Clinical Perspective Theodore E. Weltzin, MD, FAED, FAPA Medical Director of Eating Disorder Services Rogers Memorial Hospital Eating Disorders and Compulsive Behaviors Long

More information

CLASS OBJECTIVE: What is Obsessive-Compulsive Disorder? What is OCD?

CLASS OBJECTIVE: What is Obsessive-Compulsive Disorder? What is OCD? CLASS OBJECTIVE: What is Obsessive-Compulsive Disorder? Chapter 4-Anxiety Disorders What is OCD? Obsessive-compulsive disorder is an anxiety disorder that involves unwanted, What Did you see? The obsessions

More information

The Priory Group. What is obsessive-compulsive disorder?

The Priory Group. What is obsessive-compulsive disorder? The Priory Group What is obsessive-compulsive disorder? by Dr David Veale Dr Veale is a Consultant Psychiatrist at the Priory Hospital North London and the coauthor of Overcoming Obsessive Compulsive Disorder

More information

Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care

Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care CLINICAL ASSESSMENT AND DIAGNOSIS (ADULTS) Obsessive-Compulsive Disorder (OCD) is categorized by recurrent obsessions,

More information

CBT for PANS/PANDAS. Eric A. Storch, Ph.D. All Children s Hospital Guild Endowed Chair and Professor. University of South Florida

CBT for PANS/PANDAS. Eric A. Storch, Ph.D. All Children s Hospital Guild Endowed Chair and Professor. University of South Florida CBT for PANS/PANDAS Eric A. Storch, Ph.D. All Children s Hospital Guild Endowed Chair and Professor University of South Florida Treatment options remain unclear Pharmacological treatments for PANDAS/PANS

More information

Stress and Anxiety in Obsessive-Compulsive Disorder. Kieron O`Connor & Frederick Aardema

Stress and Anxiety in Obsessive-Compulsive Disorder. Kieron O`Connor & Frederick Aardema Stress and Anxiety in Obsessive-Compulsive Disorder Kieron O`Connor & Frederick Aardema Characterized by the occurrence of persistent thoughts, urges, or images that are experienced as intrusive and unwanted

More information

Cognitive Behavioral Treatment of Postpartum Onset Obsessive-Compulsive Disorder with Aggressive Obsessions

Cognitive Behavioral Treatment of Postpartum Onset Obsessive-Compulsive Disorder with Aggressive Obsessions Cognitive Behavioral Treatment of Postpartum Onset Obsessive-Compulsive Disorder with Aggressive Obsessions Lisa Christian, PhD Dept of Psychiatry, Psychology, and Obstetrics & Gynecology The Institute

More information

OCD & Anxiety: Helen Blair Simpson, M.D., Ph.D.

OCD & Anxiety: Helen Blair Simpson, M.D., Ph.D. OCD & Anxiety: Symptoms, Treatment, & How to Cope Helen Blair Simpson, M.D., Ph.D. Professor of Clinical Psychiatry, Columbia University Director of the Anxiety Disorders Clinic, New York State Psychiatric

More information

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder David A. Clark, Ph. D. Sue is a young mother of two children who developed an intense fear of contracting germs that might lead to a life-threatening infectious disease. Much of her day is spent worrying

More information

OCD. Patient Information

OCD. Patient Information OCD Patient Information 2 OBSESSIVE-COMPULSIVE DISORDER Obsessive-compulsive disorder (OCD) is a common mental health problem. Symptoms typically include recurring obsessive thoughts, and repetitive compulsions

More information

Obsessive Compulsive Disorder What you need to know to help your patients

Obsessive Compulsive Disorder What you need to know to help your patients Obsessive Compulsive Disorder What you need to know to help your patients By Renae M. Reinardy, PsyD, LP, and Jon E. Grant, MD Obsessive compulsive disorder (OCD) is a condition that affects millions of

More information

Pediatric Obsessive-Compulsive Disorder. Assessment & Treatment

Pediatric Obsessive-Compulsive Disorder. Assessment & Treatment Pediatric Obsessive-Compulsive Disorder Assessment & Treatment Prevalence Onset Gender Diagnostic Criteria Comorbidity Treatment Questions Prevalence U.S. Youth 1-3% (McKay & Storch, 2009) Higher w/ DD

More information

CBT Treatment. Obsessive Compulsive Disorder

CBT Treatment. Obsessive Compulsive Disorder CBT Treatment Obsessive Compulsive Disorder 1 OCD DEFINITION AND DIAGNOSIS NORMAL WORRIES & COMPULSIONS DYSFUNCTIONAL/ABNORMAL OBSESSIONS DSM IV DIAGNOSIS 2 OCD DIAGNOSIS DSM IV & ICD 10 A significant

More information

OBSESSIVE-COMPULSIVE AND RELATED DISORDERS

OBSESSIVE-COMPULSIVE AND RELATED DISORDERS OBSESSIVE-COMPULSIVE AND RELATED DISORDERS According to the American Psychiatric Association (APA), the publisher of the DSM-5, the major change for obsessivecompulsive disorder is the fact that it and

More information

Questions & Answers About OCD In Children and Adolescents

Questions & Answers About OCD In Children and Adolescents Questions & Answers About OCD In Children and Adolescents What is Obsessive Compulsive Disorder? Obsessive Compulsive Disorder (OCD) i s one o f the m ost comm on psychiatric illnesses affecting young

More information

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT?

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Open Learning Agency 2004 WHAT IS IT? Anxiety is a normal human feeling characterized by worry, nervousness and fear. Not only does anxiety

More information

TREATING OBSESSIVE-COMPULSIVE DISORDER WITH EXPOSURE AND RESPONSE PREVENTION Jonathan D. Huppert and Deborah A. Roth University of Pennsylvania

TREATING OBSESSIVE-COMPULSIVE DISORDER WITH EXPOSURE AND RESPONSE PREVENTION Jonathan D. Huppert and Deborah A. Roth University of Pennsylvania TREATING OBSESSIVE-COMPULSIVE DISORDER WITH EXPOSURE AND RESPONSE PREVENTION Jonathan D. Huppert and Deborah A. Roth University of Pennsylvania Exposure and Response (ritual) Prevention (EX/RP) for obsessive-compulsive

More information

Barnet, Enfield and Haringey Mental Health NHS Trust. Understanding OCD. Obsessive-Compulsive Disorder (OCD) Information for patients and carers.

Barnet, Enfield and Haringey Mental Health NHS Trust. Understanding OCD. Obsessive-Compulsive Disorder (OCD) Information for patients and carers. Barnet, Enfield and Haringey Mental Health NHS Trust Understanding OCD Obsessive-Compulsive Disorder (OCD) Information for patients and carers Page What is Obsessive-Compulsive Disorder (OCD) People with

More information

Treatments for OCD: Cognitive- Behavioural Therapy

Treatments for OCD: Cognitive- Behavioural Therapy Source: CAMH (Centre for Addiction and Mental Health) www.camh.net Treatments for OCD: Cognitive- Behavioural Therapy Obsessive-Compulsuve Disorder: An Information Guide On this page: Cognitive-Behavioural

More information

A Sierra Tucson Publication. An Introduction to Mood Disorders & Treatment Options

A Sierra Tucson Publication. An Introduction to Mood Disorders & Treatment Options A Sierra Tucson Publication An Introduction to Mood Disorders & Treatment Options 0 Introduction The term mood disorder refers to a category that includes the following mental health issues: Anxiety Disorders

More information

Taming the OCD Monster Tips & Tricks for Living Sanely with OCD

Taming the OCD Monster Tips & Tricks for Living Sanely with OCD Taming the OCD Monster Tips & Tricks for Living Sanely with OCD January 13, 2016 FAA Family Resource Meeting Presented by: Gwennyth Palafox, Ph.D. What is Obsessive Compulsive Disorder (OCD)? Is an anxiety

More information

Intensive Treatment Program Description: The Houston OCD Program in Houston, Texas June 2009

Intensive Treatment Program Description: The Houston OCD Program in Houston, Texas June 2009 1. When did you open your program? Intensive Treatment Program Description: The Houston OCD Program in Houston, Texas June 2009 In September of 2000, we opened a residential treatment program for OCD at

More information

INTENSIVE TREATMENT FOR SEVERE OCD. How Far Do You Go?

INTENSIVE TREATMENT FOR SEVERE OCD. How Far Do You Go? Anxiety Disorders Association of America 30 th Annual Conference 2010 INTENSIVE TREATMENT FOR SEVERE OCD How Far Do You Go? Westwood Institute for Anxiety Disorders, Inc. PRESENTERS: Eda Gorbis, Ph.D.,

More information

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems

More information

Exposure and Response Prevention (ERP) Therapy for OCD in Children and Adolescents

Exposure and Response Prevention (ERP) Therapy for OCD in Children and Adolescents Exposure and Response Prevention (ERP) Therapy for OCD in Children and Adolescents Dr. Stacy Shaw Welch Anxiety and Stress Reduction Center Part of the Evidence Based Treatment Centers of Seattle September

More information

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder South West London and St George s Mental Health NHS Trust A National Service for Obsessive-Compulsive Disorder and Body Dysmorphic Disorder Springfield University Hospital A Referrer s Guide 1 Who we are

More information

Depression Assessment & Treatment

Depression Assessment & Treatment Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting

More information

Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) Obsessive Compulsive Disorder (OCD) Introduction Obsessive compulsive disorder, or OCD, is a type of anxiety disorder. OCD causes repeated upsetting thoughts called obsessions. To try and get rid of these

More information

Introduction to Exposure Therapy for Obsessive Compulsive Disorder

Introduction to Exposure Therapy for Obsessive Compulsive Disorder Introduction to Exposure Therapy for Obsessive Compulsive Disorder Katherine L. Muller, Psy.D., ABPP Director & Founder Valley Center for Cognitive Behavioral Therapy Center Valley, PA The Exposure Myth

More information

Issues in OCD Resistance: Co-Morbidity and Merged Vs Unmerged OCD Page 1 Jonathan Grayson, Ph.D.

Issues in OCD Resistance: Co-Morbidity and Merged Vs Unmerged OCD Page 1 Jonathan Grayson, Ph.D. Issues in OCD Resistance: Co-Morbidity and Merged Vs Unmerged OCD Page 1 Jonathan Grayson, Ph.D. I. Introduction A. Treatment resistance comes in many forms, which all of us have been addressing over the

More information

SOMERSET DUAL DIAGNOSIS PROTOCOL OCTOBER 2011

SOMERSET DUAL DIAGNOSIS PROTOCOL OCTOBER 2011 SOMERSET DUAL DIAGNOSIS PROTOCOL OCTOBER 2011 This document is intended to be used with the Somerset Dual Diagnosis Operational Working guide. This document provides principles governing joint working

More information

Child & Adolescent Anxiety: Psychopathology and Neuroscience

Child & Adolescent Anxiety: Psychopathology and Neuroscience bbrfoundation.org Child & Adolescent Anxiety: Psychopathology and Neuroscience Daniel S. Pine, M.D. Chief, Child & Adolescent Research Mood & Anxiety Disorders Program National Institute of Mental Health

More information

MOLINA HEALTHCARE OF CALIFORNIA

MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina

More information

Anxiety and Education Impact, Recognition & Management Strategies

Anxiety and Education Impact, Recognition & Management Strategies Anxiety and Education Impact, Recognition & Management Strategies Dr Amanda Gamble Centre for Emotional Health (formerly MUARU) Macquarie University, Sydney. WHY SHOULD I BE CONCERNED? 1 Prevalence of

More information

Obsessive Compulsive Disorders. Treatment

Obsessive Compulsive Disorders. Treatment Obsessive Compulsive Disorders Treatment Models Biological Psychodynamic Learning Cognitive Treatment Biological Factors Genetics Lenane et al 1990» Interviewed 146 relatives of 45 children and adolescents

More information

How to Help Your Child. A Parent s Guide to OCD. Obsessive Compulsive Foundation of Metropolitan Chicago

How to Help Your Child. A Parent s Guide to OCD. Obsessive Compulsive Foundation of Metropolitan Chicago How to Help Your Child A Parent s Guide to OCD Obsessive Compulsive Foundation of Metropolitan Chicago If y o u r c h i l d h a s O b s e s s i v e C o m p u l s i v e D i s o r d e r : You are not alone.

More information

Obsessive-compulsive disorder

Obsessive-compulsive disorder Obsessive-compulsive disorder Obsessive-compulsive disorder An anxiety disorder characterized by involuntary thoughts, ideas, urges, impulses, or worries that run through one s mind (obsessions) and purposeless

More information

Abnormal Psychology PSYCH 40111

Abnormal Psychology PSYCH 40111 Abnormal Psychology PSYCH 40111 Somatoform and Dissociative Disorders Somatoform Disorders Soma Meaning Body Overly preoccupied with their health or body appearance No identifiable medical condition causing

More information

Psychosocial risk factors and treatment for children and adolescents with OCD

Psychosocial risk factors and treatment for children and adolescents with OCD Psychosocial risk factors and treatment for children and adolescents with OCD Dr. Marian Kolta Psychologist The Royal Children s Hospital Integrated Mental Health Program Learning Aims Outline: Define

More information

ALEXIAN BROTHERS CENTER FOR ANXIETY AND OBSESSIVE COMPULSIVE DISORDERS

ALEXIAN BROTHERS CENTER FOR ANXIETY AND OBSESSIVE COMPULSIVE DISORDERS ALEXIAN BROTHERS CENTER FOR ANXIETY AND OBSESSIVE COMPULSIVE DISORDERS Begin Here One call is all it takes to access any of the services provided by Alexian Brothers Behavioral Health Hospital. Trained

More information

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder South West London and St George s Mental Health NHS Trust Trustwide Service for Obsessive-Compulsive Disorder and Body Dysmorphic Disorder Springfield University Hospital A Referrer s Guide 1 Who we are

More information

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí=

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= `çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= Overview: Common Mental What are they? Disorders Why are they important? How do they affect

More information

COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP)

COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) The European Medicines Agency Evaluation of Medicines for Human Use London, 20 January 2005 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE ON CLINICAL INVESTIGATION OF MEDICINAL PRODUCTS

More information

Depression and Mental Health:

Depression and Mental Health: Depression and Mental Health: A Psychiatrist s Perspective Peter M. Lake, MD Medical Director Rogers Memorial Hospital Oconomowoc Depression The Intersection of Hope, Medicine and Research Marquette University

More information

Emily Anderson, PhD Christen Sistrunk, MA, LPC Naomi Zwecker, PhD Jennifer Sy, PhD Jessica Gerfen, PhD

Emily Anderson, PhD Christen Sistrunk, MA, LPC Naomi Zwecker, PhD Jennifer Sy, PhD Jessica Gerfen, PhD Emily Anderson, PhD Christen Sistrunk, MA, LPC Naomi Zwecker, PhD Jennifer Sy, PhD Jessica Gerfen, PhD What are unacceptable thoughts? Experienced as unwanted and intrusive Often sexual, violent, or blasphemous

More information

Unwanted Mental Intrusions in Anxiety Disorders: A Modified Cognitive-Behavioral Approach

Unwanted Mental Intrusions in Anxiety Disorders: A Modified Cognitive-Behavioral Approach Unwanted Mental Intrusions in Anxiety Disorders: A Modified Cognitive-Behavioral Approach David A. Clark, PhD University of New Brunswick, Canada ADAA Conference, April 12, 2012 Unwanted Intrusive Thoughts

More information

Sunderland Psychological Wellbeing Service

Sunderland Psychological Wellbeing Service Sunderland Psychological Wellbeing Service Information for Referrers Offering a range of psychological therapies across Sunderland. To make a referral call 0191 566 5454 A partnership between Northumberland,

More information

Understanding obsessivecompulsive. disorder. Obsessive-compulsive

Understanding obsessivecompulsive. disorder. Obsessive-compulsive Understanding obsessivecompulsive disorder Obsessive-compulsive disorder Understanding obsessivecompulsive disorder Obsessive-compulsive disorder (OCD) is described as an anxiety disorder. An obsession

More information

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS E-Resource December, 2013 SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS Between 10-18% of adults in the general population and up to 50% of adults in the primary care setting have difficulty sleeping. Sleep

More information

AUTISM SPECTRUM DISORDERS

AUTISM SPECTRUM DISORDERS AUTISM SPECTRUM DISORDERS JAGWINDER SANDHU, MD CHILD, ADOLESCENT AND ADULT PSYCHIATRIST 194 N HARRISON STREET PRINCETON, NJ 08540 PH: 609 751 6607 Staff Psychiatrist Carrier clinic Belle Mead NJ What is

More information

Tourette syndrome and co-morbidity

Tourette syndrome and co-morbidity Tourette syndrome and co-morbidity Nanette M.M. Mol Debes, M.D., Ph.D. Tourette clinic, Herlev University Hospital, Denmark Outline of presentation Research project Herlev University Hospital Denmark Prevalence

More information

Presentation Notes: Stop the Anxiety! Stop the Anxiety! Anxiety Disorders. Counseling and Mental Health. Stop the Anxiety!

Presentation Notes: Stop the Anxiety! Stop the Anxiety! Anxiety Disorders. Counseling and Mental Health. Stop the Anxiety! Presentation Notes: Slide 1 Anxiety Disorders Counseling and Mental Health Slide 2 Copyright Copyright Texas Education Agency, 2012. These Materials are copyrighted and trademarked as the property of the

More information

Intensive Treatment Program Interview with Diane Davey, RN, MBA of The OCD Institute at McLean Hospital in Belmont, Massachusetts February 2009

Intensive Treatment Program Interview with Diane Davey, RN, MBA of The OCD Institute at McLean Hospital in Belmont, Massachusetts February 2009 Intensive Treatment Program Interview with Diane Davey, RN, MBA of The OCD Institute at McLean Hospital in Belmont, Massachusetts February 2009 1. When did you open your program? The OCD Institute opened

More information

Clinical Applications of Mindfulness-Enhanced Cognitive Behavioral Therapy for OCD

Clinical Applications of Mindfulness-Enhanced Cognitive Behavioral Therapy for OCD Clinical Applications of Mindfulness-Enhanced Cognitive Behavioral Therapy for OCD Jon Hershfield, MFT & Jonathan Grayson, Ph.D. who had somewhere better to be Anxiety and Depression Association of America

More information

309.28 F43.22 Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with disturbance of conduct

309.28 F43.22 Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with disturbance of conduct Description ICD-9-CM Code ICD-10-CM Code Adjustment reaction with adjustment disorder with depressed mood 309.0 F43.21 Adjustment disorder with depressed mood Adjustment disorder with anxiety 309.24 F43.22

More information

3/10/2015. Help! My Brain s Stuck! Repetitive Behaviours (RBs) in Children and Adolescents. Conflicts of Interest. Test YOUR Repetitive Behaviour IQ

3/10/2015. Help! My Brain s Stuck! Repetitive Behaviours (RBs) in Children and Adolescents. Conflicts of Interest. Test YOUR Repetitive Behaviour IQ Help! My Brain s Stuck! Repetitive Behaviours (RBs) in Children and Adolescents None to disclose Conflicts of Interest Drs. Kim Edwards, Holly McGinn, & Sandra Mendlowitz Ontario Psychological Association

More information

When Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder National Institute of Mental Health

When Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder National Institute of Mental Health When Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder National Institute of Mental Health U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental

More information

Obsessive- Compulsive Disorder:

Obsessive- Compulsive Disorder: Obsessive- Compulsive Disorder: When Unwanted Thoughts Take Over Do you feel the need to check and re - check things over and over? Do you have the same thoughts constantly? Do you feel a very strong need

More information

Martin Harrow s Long-Term Study of. Psychotic Patients

Martin Harrow s Long-Term Study of. Psychotic Patients Martin Harrow s Long-Term Study of Patient Enrollment Psychotic Patients 64 schizophrenia patients 81 patients with other psychotic disorders 37 psychotic bipolar patients 28 unipolar psychotic patients

More information

A Guide to Cognitive- Behavioural Therapy (CBT)

A Guide to Cognitive- Behavioural Therapy (CBT) A Guide to Cognitive- Behavioural Therapy (CBT) Cognitive-behavioural Therapy (CBT) aims to help you to change the way that you think, feel and behave. It is used as a treatment for various mental health

More information

University of South Florida OCD, Anxiety, and Related Disorders Behavioral Treatment Program

University of South Florida OCD, Anxiety, and Related Disorders Behavioral Treatment Program OCD and Related Disorders Clinic Profile University of South Florida OCD, Anxiety, and Related Disorders Behavioral Treatment Program Clinic/Program Director: Adam B. Lewin, PhD, ABPP Name of Intake Coordinator:

More information

Psychological treatments for Anxiety and Depression

Psychological treatments for Anxiety and Depression Psychological treatments for Anxiety and Depression Katy Grazebrook Clinical Lead, Greenwich Time To Talk Consultant Clinical Psychologist Wednesday 18 March 2015 Plan of the presentation Summary of NICE

More information

Diagnosis and Treatment of Bipolar Disorder. Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016

Diagnosis and Treatment of Bipolar Disorder. Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016 Diagnosis and Treatment of Bipolar Disorder Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016 Points to Cover What is the defining characteristic of Bipolar Disorder? Bipolar I vs. Bipolar II

More information

Psychology & Psychophysiology of Disordered Eating & Eating Disorders Claus Vögele Institute for Health and Behaviour University of Luxembourg

Psychology & Psychophysiology of Disordered Eating & Eating Disorders Claus Vögele Institute for Health and Behaviour University of Luxembourg Psychology & Psychophysiology of Disordered Eating & Eating Claus Vögele Institute for Health and Behaviour University of Luxembourg 1 Don t worry, eat happy! Eating as emotion-regulation strategy but

More information

MENTAL HEALTH OBSESSIVE COMPULSIVE DISORDER

MENTAL HEALTH OBSESSIVE COMPULSIVE DISORDER MENTAL HEALTH OBSESSIVE COMPULSIVE DISORDER WHAT IS OBSESSIVE COMPULSIVE DISORDER? Obsessive compulsive disorder (OCD) is an anxiety disorder that usually develops in adolescence or young adulthood. However,

More information

Co-Occurring Substance Use and Mental Health Disorders. Joy Chudzynski, PsyD UCLA Integrated Substance Abuse Programs

Co-Occurring Substance Use and Mental Health Disorders. Joy Chudzynski, PsyD UCLA Integrated Substance Abuse Programs Co-Occurring Substance Use and Mental Health Disorders Joy Chudzynski, PsyD UCLA Integrated Substance Abuse Programs Introduction Overview of the evolving field of Co-Occurring Disorders Addiction and

More information

The Impact of Anxiety on Student Performance?

The Impact of Anxiety on Student Performance? The Impact of Anxiety on Student Performance? Dr Heidi Lyneham WHYSHOULD I BE CONCERNED? 1 Macquarie University 1 Prevalence of Anxiety Ford et al (2003): British Child & Adolescent Mental Health Survey

More information

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population

More information

Assessment and Treatment of Obsessive Compulsive Disorder Children and Adolescents

Assessment and Treatment of Obsessive Compulsive Disorder Children and Adolescents Assessment and Treatment of Obsessive Compulsive Disorder Children and Adolescents Martha J. Molly Faulkner, PhD, CNP, LISW University of New Mexico Health Sciences Center Children s Psychiatric Center

More information

Anxiety, anxiety disorders, somatoform disorders. Zoltán Hidasi

Anxiety, anxiety disorders, somatoform disorders. Zoltán Hidasi Anxiety, anxiety disorders, somatoform disorders Zoltán Hidasi Anxiety Definition Normal anxiety Signs and symptoms Anxiety disorders Anxiolitic therapy Special importance for dentists Fear v. anxiety

More information

The Urge to React : Obsessive Compulsive Disorder and Huntington s Disease. John Barkenbus, MD North Carolina Neuropsychiatry Charlotte Clinic

The Urge to React : Obsessive Compulsive Disorder and Huntington s Disease. John Barkenbus, MD North Carolina Neuropsychiatry Charlotte Clinic The Urge to React : Obsessive Compulsive Disorder and Huntington s Disease John Barkenbus, MD North Carolina Neuropsychiatry Charlotte Clinic Disclaimer The information provided by speakers in workshops,

More information

Not All That Swings Is Bipolar: Diagnosis and Treatment of Borderline Personality Disorder

Not All That Swings Is Bipolar: Diagnosis and Treatment of Borderline Personality Disorder Not All That Swings Is Bipolar: Diagnosis and Treatment of Borderline Personality Disorder Michael D. Jibson, MD, PhD Professor of Psychiatry University of Michigan Disclosure In the past 12 months I have

More information

International OCD Foundation Institutional Member Neurobehavioral Institute

International OCD Foundation Institutional Member Neurobehavioral Institute International OCD Foundation Institutional Member Neurobehavioral Institute 1. When did you open your program? Our program started in 1998 as a pediatric Obsessive Compulsive Disorder and Related Conditions

More information

Treating Anxiety and Depression: Differences, Similarities, and What to Do First. Cindy J. Aaronson, MSW, PhD Jeremy Coplan, MD

Treating Anxiety and Depression: Differences, Similarities, and What to Do First. Cindy J. Aaronson, MSW, PhD Jeremy Coplan, MD Treating Anxiety and Depression: Differences, Similarities, and What to Do First Cindy J. Aaronson, MSW, PhD Jeremy Coplan, MD Treating Anxiety and Depression: Differences, Similarities, and What to Do

More information

Autism Spectrum Disorders and Comorbid Conditions. Judith Miller, PhD January 2012

Autism Spectrum Disorders and Comorbid Conditions. Judith Miller, PhD January 2012 Autism Spectrum Disorders and Comorbid Conditions Judith Miller, PhD millerj3@email.chop.edu January 2012 Educational Objectives Discuss the most frequent comorbid psychiatric conditions Describe the process

More information

Intensive Treatment Program Description: NeuroBehavioral Institute in Weston, Florida July 2009

Intensive Treatment Program Description: NeuroBehavioral Institute in Weston, Florida July 2009 Intensive Treatment Program Description: NeuroBehavioral Institute in Weston, Florida July 2009 1. When did you open your program? Our program started in 1998 as a pediatric Obsessive Compulsive Disorder

More information

Cognitive Behavioral Therapy for PTSD. Dr. Edna B. Foa

Cognitive Behavioral Therapy for PTSD. Dr. Edna B. Foa Cognitive Behavioral Therapy for PTSD Presented by Dr. Edna B. Foa Center for the Treatment and Study of Anxiety University of Pennsylvania Ref # 3 Diagnosis of PTSD Definition of a Trauma The person has

More information

Clinical guideline Published: 29 November 2005 nice.org.uk/guidance/cg31

Clinical guideline Published: 29 November 2005 nice.org.uk/guidance/cg31 Obsessive-compulsive e disorder and body dysmorphic disorder: treatment Clinical guideline Published: 29 November 2005 nice.org.uk/guidance/cg31 NICE 2005. All rights reserved. Contents Introduction...

More information

and body dysmorphic disorder (BDD) in adults, children and young people Issue date: November 2005

and body dysmorphic disorder (BDD) in adults, children and young people Issue date: November 2005 Issue date: November 2005 Treating obsessivecompulsive disorder (OCD) and body dysmorphic disorder (BDD) in adults, children and young people Understanding NICE guidance information for people with OCD

More information

DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D.

DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D. DSM 5 AND DISRUPTIVE MOOD DYSREGULATION DISORDER Gail Fernandez, M.D. GOALS Learn DSM 5 criteria for DMDD Understand the theoretical background of DMDD Discuss background, pathophysiology and treatment

More information

Bipolar Disorder A detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping.

Bipolar Disorder A detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping. ANXIETY DISORDERS Anxiety Disorders A detailed booklet that describes the symptoms, causes, and treatments of the major anxiety disorders, with information on getting Link: http://www.nimh.nih.gov/publicat/anxiety.cfm

More information

OCD and disordered eating: When OCD masquerades as eating disorders

OCD and disordered eating: When OCD masquerades as eating disorders OCD and disordered eating: When OCD masquerades as eating disorders Brigette A. Erwin, PhD Director, OCD Program Anxiety and Agoraphobia Treatment Center Bala Cynwyd, PA A presentation conducted at the

More information

Developing a Spectrum of Care for Pediatric OCD. The Bradley Model

Developing a Spectrum of Care for Pediatric OCD. The Bradley Model Developing a Spectrum of Care for Pediatric OCD The Bradley Model Brady G Case, MD Abbe M Garcia, PhD Intensive Program for OCD & Health Services Research Program BRADLEY HOSPITAL Department of Psychiatry

More information

Okami Study Guide: Chapter 13 1

Okami Study Guide: Chapter 13 1 Okami Study Guide: Chapter 13 1 Chapter Test 1. This is the organized set of criteria for diagnosing psychological disorders used in the United States. a. Diagnostic and Statistical Manual of Mental Disorders

More information

Music therapy as a treatment for schizophrenia

Music therapy as a treatment for schizophrenia Music therapy as a treatment for schizophrenia George Sismey George Gillett University of Oxford October 2015 The question Scenario: 42 year old man with schizophrenia has read a newspaper article suggesting

More information

Assessment and Diagnosis of DSM-5 Substance-Related Disorders

Assessment and Diagnosis of DSM-5 Substance-Related Disorders Assessment and Diagnosis of DSM-5 Substance-Related Disorders Jason H. King, PhD (listed on p. 914 of DSM-5 as a Collaborative Investigator) j.king@lecutah.com or 801-404-8733 www.lecutah.com D I S C L

More information

[KQ 804] FEBRUARY 2007 Sub. Code: 9105

[KQ 804] FEBRUARY 2007 Sub. Code: 9105 [KQ 804] FEBRUARY 2007 Sub. Code: 9105 (Revised Regulations) Theory : Two hours and forty minutes Q.P. Code: 419105 Maximum : 100 marks Theory : 80 marks M.C.Q. : Twenty minutes M.C.Q. : 20 marks 1. A

More information

Brief Review of Common Mental Illnesses and Treatment

Brief Review of Common Mental Illnesses and Treatment Brief Review of Common Mental Illnesses and Treatment Presentations to the Joint Subcommittee to Study Mental Health Services in the 21st Century September 9, 2014 Jack Barber, M.D. Medical Director Virginia

More information

Scott E. Hannan, Ph.D.

Scott E. Hannan, Ph.D. Scott E. Hannan, Ph.D. Clinical Psychologist Connecticut license: #002540 Educational History Fordham University, Bronx, NY: 1996-2002, Ph.D., Clinical Psychology Pre-doctoral Project: Taxometric analysis

More information

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder When Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder National Institute of Mental Health U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Mental

More information

Emotional Maturity Profile of Adult Family Members of Person with OCD

Emotional Maturity Profile of Adult Family Members of Person with OCD The International Journal of Indian Psychology ISSN 248-96 (e) ISSN: 249-429 (p) Volume, Issue, DIP: C0009VI20 http://www.ijip.in October December, 20 ABSTRACT Emotional Maturity Profile of Adult Family

More information

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,

More information

An Illness Like Any Other

An Illness Like Any Other An Illness Like Any Other Mental Illnesses are Brain Disorders NAMI San Diego Helpline (619) 543-1434 (800) 523-5933 www.namisandiego.org information@namisd.org 4480 30th Street San Diego, CA. 92116 1

More information

Maintenance treatment for obsessivecompulsive disorder: Findings from a naturalistic setting

Maintenance treatment for obsessivecompulsive disorder: Findings from a naturalistic setting ANNALS OF CLINICAL PSYCHIATRY ANNALS OF CLINICAL PSYCHIATRY 2015;27(1):25-32 RESEARCH ARTICLE Maintenance treatment for obsessivecompulsive disorder: Findings from a naturalistic setting Eric D. Peselow,

More information

Effective interventions in treating the symptoms of obsessive-compulsive disorder in children and adolescents

Effective interventions in treating the symptoms of obsessive-compulsive disorder in children and adolescents Pacific University CommonKnowledge Pediatrics CATs OT Critically Appraised Topics 2011 Effective interventions in treating the symptoms of obsessive-compulsive disorder in children and adolescents Michael

More information

The nature of musculoskeletal conditions

The nature of musculoskeletal conditions Bulletin 8 September 21 The nature of musculoskeletal conditions Musculoskeletal conditions are common and varied. They are characterised by high prevalence, generally late age of onset, long duration

More information

NeuroStar TMS Therapy Patient Guide for Treating Depression

NeuroStar TMS Therapy Patient Guide for Treating Depression NeuroStar TMS Therapy Patient Guide for Treating Depression This NeuroStar TMS Therapy Patient Guide for Treating Depression provides important safety and use information for you to consider about treating

More information

Understanding Mental Illness Healing Friends Training Module 1

Understanding Mental Illness Healing Friends Training Module 1 Understanding Mental Illness Healing Friends Training Module 1 Objectives To know the myths about mental illness To know the causes of mental illness To have a basic knowledge of common mental illnesses

More information

Somatoform Disorders. Somatoform Disorders. Hypochondriasis. Preoccupation with health, physical appearance and functioning

Somatoform Disorders. Somatoform Disorders. Hypochondriasis. Preoccupation with health, physical appearance and functioning Somatoform Disorders Somatoform Disorders Preoccupation with health, physical appearance and functioning No identifiable medical cause DSM-IV Somatoform Disorders Hypochondriasis Somatization disorder

More information

Cognitive behavioural therapy for obsessive compulsive disorder

Cognitive behavioural therapy for obsessive compulsive disorder Advances in Psychiatric Treatment (2007), vol. 13, 438 446 doi: 10.1192/apt.bp.107.003699 Cognitive behavioural therapy for obsessive compulsive disorder David Veale Abstract In the UK, the National Institute

More information