Abstract

Recognition, assessment and treatment of young people with obsessive compulsive disorder (OCD) and related disorders continues to be a big challenge within health care systems. Although childhood OCD is one of the more common serious mental disorders with prevalence rates of 0.25-3%, it may remain undiagnosed for years. The situation is considerably worse for a group of related disorders, which have received very little attention, particularly in young people. These related conditions include Body Dysmorphic Disorder, Hoarding Disorder, Hair Pulling Disorder and Skin Picking Disorder. OCD and related disorders impair psychosocial functioning and it may produce substantial disability for young people and their families if left untreated. Therefore, early detection and intervention, followed by effective treatments, is essential for young sufferers to minimize distress and secondary handicap. The current recommended treatments for OCD are cognitive behaviour therapy (CBT) and serotonin re-uptake inhibitors (SRIs). Both of these treatments have been validated in randomized controlled trials, and although more evidence is needed, the current consensus is that ideally all young people with OCD should be offered CBT including the technique of exposure and response prevention (ERP). Less is known about the long term outcome and unmet needs of these young patients once they become adults. While most patients respond to available treatments, a substantial number remain unwell or only achieve partial remission. New treatments are currently being tried to improve these outcomes, including memory enhancers (D-Cycloserine) and treatment protocols are being adapted for special populations, e.g. those with comorbid Autism Spectrum Disorders and OCD. Other challenges include ensuring that evidence-based treatments are adequately disseminated to non-specialist clinics, remote geographical areas and ethnic minorities. Tele-care (CBT administered via telephone or the internet) is a promising tool to disseminate these treatments and is currently being evaluated. This lecture will review the current status of research in this area, as well as efforts to disseminating available treatments to reach as many sufferers as possible.

View the original presentation by David Maitax-Cols (pdf, 92 slides).

Read the David Mataix-Cols interview.