ACTUAL ASPECTS IN THE TREATMENT OF OBSESS IVE-COMPULSIVE DISORDERS

Behavioural therapy of obsessive-compulsive disorder represents the ps ychotherapeutic treatment of first choice. The basic principle of beha vioural therapy is exposing the patient with those situations evoking obsessive thoughts or compulsions in vivo and preventing rituals by re action management. Cognitive approaches should be integrated. 50 to 70 % of patients treated show significant improvement. The treatment of O CD with serotonin reuptake inhibitors (SSRI) is well established and e qually effective. It seems likely that selective SSRI (fluoxetine, flu voxamine, paroxetine or sertraline) do not differ in their therapeutic effectiveness from clomipramine, which has proved to be the first eff ective drug in OCD, However, selective SSRI show fewer side effects. T reatment of patients with OCD needs two to three times higher dosages compared with those commonly prescribed in depression. Usually it last s 8 to 10 weeks until an improvement is observed. The therapeutic effe ctivity of a combination of behavioural therapy with SSRI is superior to a monotherapeutic approach. Further it reduces relapse rates in cas e of cessation of the psychopharmacological treatment.