Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder (OCD) is a chronic and disabling mental health condition which affects 2% of adult individuals.
The clinical presentation of OCD can differ significantly from one person to the other. However, it is characterised by the patient getting intrusive, often unpleasant repeated thoughts, images or impulses (i.e. obsession). This leads the patient to engage in repeated behaviour (i.e. compulsions) in an attempt to relieve the anxiety associated with these obsessions.
These compulsions might be in the form of a person washing their hands repeatedly or checking that the doors are locked. Unfortunately, carrying out these compulsions results only in a temporary relief of the anxiety and stress associated with the obsession and shortly after they are performed the patient’s anxiety starts building up again.
The onset of OCD is usually around late adolescence or early adult life. Some of the common obsessive thoughts patients experience are; fear of contamination, fear of harming others, fear of causing a problem and need for symmetry. Some of the common compulsions are; doing things in a ritualistic way, repeated hand washing, checking things repeatedly, repeating certain words and doing things for a certain number of times. Severe OCD can be very disabling, and it can stop people from carrying on their usual life activities.
There are a number of different treatment modalities that can help patients suffering with OCD:
- Psychological therapies include Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP).
- While medications that can be used in OCD include; Selective Serotonin Reuptake Inhibitors (SSRIs) and the Tricyclic Antidepressant Clomipramine. In treatment resistant cases adding an antipsychotic medication to other medications can be indicated. As you can see antidepressants are used to treat OCD. When compared to depression higher doses are needed and patients need to take the medication for a longer period of time before benefits are seen.
- Besides medications and psychological therapies TMS is now used to treat OCD and the Food and Drug Administration (FDA) approved the first TMS device to treat OCD in 2018.
In London TMS Centre we have special expertise in treating OCD. One of our consultant psychiatrists, Dr Ricky Sachdev, has special expertise in the diagnosis and management of OCD.
Dr Sachdev heads the OCD treatment pathway at Camden and Islington NHS Foundation Trust and is responsible for treating individuals with OCD and related disorders such as Body dysmorphic disorder who are either severely symptomatic or resistant to first line treatments.
At the same time two of our other consultant psychiatrists, Dr Mohamed Abdelghani and Dr Ilia Bountouni manage complex OCD cases in their private practices and as part of working in Complex depression, Anxiety and Trauma (CDAT) Service at Camden and Islington NHS Foundation Trust.
When and if needed we will work with colleagues from other disciplines, such as psychologists, to deliver a comprehensive and holistic management plan to patients under the care of our team who suffer from OCD.