Management guidelines for OCD OCD Key Info • • • • • Usually manifests between 5 and 15 years In pregnancy if it is related to food e.g. worry about food being contaminated -> food restriction -> food malnutrition In the post-natal period -> impairs ability to care for infant - E.g. cleaning -> dominate parent’s time and attention Obsessions and compulsions relating to infant - E.g. excessive cleaning with the baby’s items Thoughts of intentional harm to the infant are distressing but common - Most can dismiss them - People with OCD will obsess overtime and become concern about unwilling to act upon them. - Determine risk - Likely to be associated with OCD if: ➔ Experienced even when not angry or frustrated ➔ Finds the thoughts intrusive, distressing and repulsive ➔ Avoids the infant ot takes measures to reduce their risk of harming them. Management for adults and young adults • • • • Most respond best to a combination pf psychosocial and pharmacological treatment Pharmacology can be used as an adjunct to CBT with exposure and response prevention component Psychological interventions - First line - Psychoeducation ➔ Impact people living or working with person with OCD ➔ Many especially those with more severe symptoms cannot engage in psychosocial interventions until they have an initial response to pharmacotherapy - CBT with exposure and response prevention -> treatment of choice _ exposure to cues or triggers that cause anxiety Strategies to prevent acting on compulsions Initial pharmacotherapy - SSRIs and SNRIs