OCD: What Clinicians Need To Know


Obsessive Compulsive Disorder (OCD) can present in many forms. It can trigger a cascade of behaviors that result in washing, checking, and a variety of routinized behaviors. It can also drive perfectionism and rigidity, as well as intrusive, and disruptive thoughts. Many patients often feel lost, trapped, and without recourse.

And while there can be many factors that contribute to the development of OCD, a fascinating new study done by Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) in collaboration with the JMU’s Departments of Psychiatry and Neurology found that one underlying cause may be the absence of the protein SPRED2. In mouse models, Schuh and his team were able to show that without this protein, excessive grooming behavior was triggered (Schuh, 2017).

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual. When the mice in Schuh’s study were given an inhibitor to attenuate the overactive signal cascade the obsessive-compulsive symptoms improved (Schih, 2017).

This recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade, offers a new way to look at OCD. OCD patients could be responding not just to intrusive thoughts, but an overactive amygdala that results in elevated hypervigilance. Moreover, this study represents just one of the many things we are learning about a diagnosis that has been notoriously hard to identify, and perhaps even harder to treat.

OCD has many subtypes that can often appear similar to many other disorders, such as generalized anxiety, acute stress disorder, PTSD, adjustment disorder, and a variety of phobias, and understanding the etiology as well as the clinical presentation is the foundation of effective treatment. When clinicians use accurate assessment tools to diagnose OCD, as well as its various subtypes, they can then isolate the treatment strategy that will be most helpful to the patient. Further, knowledge of the related emotional, cognitive, and clinical factors that influence the progression of OCD will help clinicians adjust treatment to the patient’s specific needs and augment treatment gains.

While OCD can be difficult to detect and treat – and often the source of much distress for the patients who experience it – through a solid understanding of the most recent research on the etiology and treatment, clinicians can help patients with OCD find ways to live productive, meaningful, and healthy lives.

Related Online Continuing Education (CE) Course:

Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD) is a 3-hour online continuing education (CE/CEU) course that reviews the diagnosis, assessment and treatment strategies for OCD. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, unwanted, and anxiety-provoking thoughts, images, impulses and rituals that are performed to alleviate the accompanying distress. Because OCD is a heterogeneous disorder with several subtypes, assessing, diagnosing, and treating it can be challenging. Further, the presentation of varying symptoms may be considered to be OC Related Disorders. Being able to make differential diagnoses and treatment recommendations are essential in clinical work with the many patients that present with the spectrum of OC problems. Specific behavioral strategies have been developed and validated in the literature that target the various manifestations of OCD and related disorders. The first part of the course offers information on the neurobiology, diagnosis and assessment tools, including the various subtypes, and highlights important topics to be taken into consideration during the process. Emotional and cognitive factors are outlined that seem to play important roles in the diagnosis and the course of episodes. The next section is dedicated to describing the clinical factors of and differential aspects of the OC Related Disorders and their prevalence. A case study follows that outlines the precipitating events, assessment, and behavioral treatment of a college student who is struggling to maintain and overcome her OCD. The final section describes effective treatment and coping strategies and augmentations that help to maintain treatment gains. Course #30-95 | 2017 | 60 pages | 20 posttest questions

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