Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

Adelar Pedro Franz, Mariana Paim, Rafael Moreno de Araújo, Virgínia de Oliveira Rosa, Ísis Mendes Barbosa, Carolina Blaya, Ygor Arzeno Ferrão
2013 Trends in Psychiatry and Psychotherapy  
Obsessive-compulsive disorder (OCD) is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine) published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians
more » ... ing with refractory OCD patients should: 1) review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2) review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3) consider non-conventional pharmacological approaches; 4) consider non-conventional psychotherapeutic approaches; and 5) consider neurobiological approaches.
doi:10.1590/s2237-60892013000100004 pmid:25923183 fatcat:h5hojxjvzjchxla5d4egwosp7i