GPs to receive OCD guidance

Doctors in England and Wales are to receive new guidelines on identifying and treating obsessive-compulsive disorder (OCD).

OCD is characterised by obsessive and irrational thoughts and urges, as well as compulsive behaviour, such as repeated washing or cleaning and constantly checking items such as electrical appliances and locks.

The disorder can occur in people of all ages, but most commonly begins in childhood or adolescence.

The new guidance, issued by the National Institute for Health and Clinical Excellence and the National Collaborating Centre for Mental Health, details the symptoms of the disorder and guidance on suitable treatments.

The guidance recommends that psychological treatments, such as cognitive behavioural therapy (CBT), including exposure and response prevention, be offered in the first instance to children, young people and adults with mild to moderate OCD. The use of a group of anti-depressants known as selective serotonin re-uptake inhibitors (SSRIs) is recommended for patients with severe OCD, or those who do not respond to psychological treatments.

The guidance also covers another, unrelated, disorder, known as body dysmorphic disorder (BDD), which is characterised by an excessive preoccupation with minor or imagined physical imperfections.

The guidance said that BDD sufferers should be offered either a course of SSRIs or CBT, which addresses the key features of the disorder.

Andrew Dillion, Chief Executive of NICE said: “OCD is very common. Some studies suggest it is the fourth most common mental disorder after depression, alcohol and substance abuse and social phobia with a lifetime prevalence of about 1-2%. The condition often goes unrecognised and untreated and we hope the guidelines will help raise awareness of this distressing condition, which, in most cases, can be effectively treated.”

Dr Isobel Heyman, Consultant Child and Adolescent Psychiatrist, Maudsley and Great Ormond Street Hospitals, London said about 1% of children and young people suffer from OCD. She said: “If OCD is left undetected and untreated, it can cause marked psychological distress and also disrupt social, educational and emotional development, leading to significant disability. This guideline should help raise awareness amongst the parents and carers of young people of the signs to look out for to ensure young people with OCD receive access to the treatments they need.”

Charities OCD Action and OCD-UK both welcomed the guidelines. Ashley Fulwood, Chief Executive of OCD-UK said: “The NICE guidelines are undoubtedly a step in the right direction and we hope they will also lead to accurate and earlier diagnosis of OCD, which, on average is only diagnosed some 7 to 12 years after its onset.”

However, Piers Watson, Chairman of OCD Action, said: “These guidelines, however, are only a first step in making appropriate treatment available to all sufferers. How quickly can the yawning gap be bridged that presently exists between the many sufferers and the few available healthcare practitioners specifically trained to treat these illnesses? This is now the challenge.”

(KMcA/SP)