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VOLUME 4 Obsessive-Compulsive Disorder Second Edition Edited by Mario Maj University of Naples, Italy Norman Sartorius University of Geneva, Switzerland Ahmed Okasha Ain Shams University, Cairo, Egypt Joseph Zohar Tel Aviv University, Israel WPA Series Evidence and Experience in Psychiatry VOLUME 4 Obsessive-Compulsive Disorder Second Edition WPA Series Evidence and Experience in Psychiatry Other Titles in the WPA Series Evidence and Experience in Psychiatry Volume 1ÐDepressive Disorders, Second Edition Mario Maj and Norman Sartorius Volume 2ÐSchizophrenia, Second Edition Mario Maj and Norman Sartorius Volume 3ÐDementia, Second Edition Mario Maj and Norman Sartorius Volume 5ÐBipolar Disorder Mario Maj, Hagop S. Akiskal, Juan Jose LoÂpez-Ibor and Norman Sartorius VOLUME 4 Obsessive-Compulsive Disorder Second Edition Edited by Mario Maj University of Naples, Italy Norman Sartorius University of Geneva, Switzerland Ahmed Okasha Ain Shams University, Cairo, Egypt Joseph Zohar Tel Aviv University, Israel WPA Series Evidence and Experience in Psychiatry Copyright # 2002 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England Telephone (+44) 1243 779777 Email (for orders and customer service enquiries): [email protected] Visit our Home Page on www.wileyeurope.com or www.wiley.com First Edition printed in 2000. All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patients Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of the Publisher. Requests to the Publisher should be addressed to the Permissions Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England, or emailed to [email protected], or faxed to (+44) 1243 770571. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the Publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Other Wiley Editorial Offices John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore 129809 John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0-470-84966-5 Typeset in 10/12pt Times by Kolam Information Services Pvt. Ltd, Pondicherry, India Printed and bound in Great Britain by TJ International, Padstow, Cornwall. This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at least two trees are planted for each one used for paper production. Contents List of Review Contributors xi Preface xiii CHAPTER 1 DIAGNOSIS OF OBSESSIVE-COMPULSIVE DISORDER 1 Diagnosis of Obsessive-Compulsive Disorder: A Review 1 A. Okasha COMMENTARIES 1.1 Obsessive-Compulsive Disorder: Towards a Diagnosis by Etiology 20 G. Nestadt 1.2 Assessment and Management of Obsessive-Compulsive Disorder 22 A. Rothenberg 1.3 Subtypes of Obsessive-Compulsive Disorder? 25 M.A. Riddle 1.4 Dissecting Obsessive-Compulsive Disorder into Subtypes 26 M.L. Berthier 1.5 The Diagnosis of Obsessive-Compulsive Disorder and Its Subtypes 29 E.C. Miguel and A.G. Hounie 1.6 Obsessive-Compulsive Symptoms: Implications for Treatment 32 L. Ravizza, U. Albert, G. Maina and F. Bogetto 1.7 Insight and Psychological Aspects of Obsessive-Compulsive Disorder 34 Y.G. Papakostas and G.N. Christodoulou 1.8 The Role of Overvalued Ideas and Biological Markers in the Diagnosis of Obsessive-Compulsive Disorder 37 F. Neziroglu vi CONTENTS 1.9 Research on Diagnosis of Obsessive-Compulsive Disorder in Latin America 39 H. Nicolini CHAPTER 2 PHARMACOLOGICAL TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER 43 Pharmacological Treatment of Obsessive-Compulsive Disorder: A Review 43 J. Zohar, Y. Sasson, M. Chopra, D. Amital and I. Iancu COMMENTARIES 2.1 Pharmacotherapy of Obsessive-Compulsive Disorder: Accomplishment, Unanswered Questions and New Directions 62 T.A. Pigott 2.2 Beyond Serotonin Reuptake Inhibitors: Do We Have Our Second Wind? 65 C.J. McDougle 2.3 Future Pharmacotherapy for Obsessive-Compulsive Disorder: 5-HT2 Agonists and Beyond 68 P.L. Delgado 2.4 Comments on the Pharmacological Treatment of Obsessive-Compulsive Disorder 71 M.R. Mavissakalian 2.5 The Expanding Obsessive-Compulsive Disorder Evidence Base 73 L.M. Koran 2.6 The Heterogeneity of Obsessive-Compulsive Disorder and Its Implications for Treatment 76 L. Bellodi 2.7 Pharmacotherapy of Obsessive-Compulsive Disorder: Questions for the Next Decade 79 M. Arato 2.8 Recent Progress and Open Issues in the Pharmacological Approach to Obsessive- Compulsive Disorder 82 J.A. Yaryura -Tobias 2.9 Treatment and Neurobiology of Obsessive- Compulsive Disorder 84 J.A. den Boer CONTENTS vii 2.10 Obsessive-Compulsive Disorder: Pharmacological Decision 86 J. Ananth 2.11 Serotonergic Antidepressants in Obsessive- Compulsive Personality Disorder 89 M. Ansseau 2.12 Drug Treatment of Obsessive-Compulsive Disorder: Dark Past, Bright Present, but Glowing Future 91 P. Blier CHAPTER 3 PSYCHOTHERAPIES FOR OBSESSIVE- COMPULSIVE DISORDER 93 Psychotherapies for Obsessive-Compulsive Disorder: A Review 93 E.B. Foa and M.E. Franklin COMMENTARIES 3.1 Effective Behavioural Therapy Constrained: Dissemination is the Issue 116 J.H. Greist 3.2 Can We Enhance the Effects of Cognitive-Behavioural Therapy in Obsessive-Compulsive Disorder? 119 P.M.G. Emmelkamp 3.3 Obsessive-Compulsive Disorder: Symptom-directed Behavioural Techniques and Beyond 122 I. Hand 3.4 Is the Combination of Antidepressants with Cognitive-Behavioural Therapy the Most Potent Treatment Possibility in Obsessive-Compulsive Disorder? 125 A.J.L.M. van Balkom 3.5 Cognitive Therapy and Behavioural Therapy in Obsessive-Compulsive Disorder: in Search of the Process 129 J. Cottraux 3.6 Obsessional Problems: Newer Cognitive-Behavioural Approaches Are a Work in Progress 131 P.M. Salkovskis 3.7 Current Issues in the Use of Behavioural Therapy for Obsessive-Compulsive Disorder 134 K.A. Kobak and B.C. Riemann viii CONTENTS 3.8 Cognitive-Behavioural Therapy and Integrated Approaches in the Treatment of Obsessive- Compulsive Disorder 136 F. Hohagen 3.9 Mindful Awareness: the Key to Successful Self-directed Treatment Strategies 139 J.M. Schwartz 3.10 The Role of Cognitive Therapy in the Treatment of Obsessive-Compulsive Disorder 142 L.M. Drummond 3.11 Psychodynamic Treatment of Obsessive-Compulsive Conditions 144 D. Shapiro CHAPTER 4 CHILD AND ADOLESCENT OBSESSIVE- COMPULSIVE DISORDER 147 Child and Adolescent Obsessive-Compulsive Disorder: A Review 147 M.F. Flament and D. Cohen COMMENTARIES 4.1 Theoretical and Clinical Implications of the Spectrum of Childhood Obsessionality 184 R.A. King 4.2 Developmental Perspectives in Pediatric Onset Obsessive-Compulsive Disorder 187 D.A. Geller 4.3 A Concept of Disorder in Some Disorder 190 D. Bolton 4.4 Obsessive-Compulsive Disorder: a Model for Closing the ``Gap'' between Adult and Pediatric Psychiatry 192 J. DeVeaugh-Geiss 4.5 The Spectrum of Obsessive-Compulsive Symptoms in Children and Adolescents 195 P.H. Thomsen 4.6 Obsessive-Compulsive Disorder in Children and Adolescents: Narrowing the Gap between Knowledge and Clinical Practice 196 J.G. Simeon 4.7 Obsessive-Compulsive Disorder in Children and Adolescents: Data from a Developing Country 198 C.E. Berganza CONTENTS ix CHAPTER 5 OBSESSIVE-COMPULSIVE SPECTRUM DISORDERS 203 Obsessive-Compulsive Spectrum Disorders: A Review 203 E. Hollander and J. Rosen COMMENTARIES 5.1 The Obsessive-Compulsive Spectrum: Promises and Pitfalls 225 K.A. Phillips 5.2 Understanding the Obsessive-Compulsive Spectrum: a Four-factor Model of Obsessive-Compulsive Symptoms 228 D. Watson and K. Wu 5.3 Extremes of Impulse Control and Serotonin/Frontal Lobe Pathophysiology 230 W. Kaey 5.4 The Obsessive-Compulsive Spectrum: Fact or Fancy? 233 D.W. Black 5.5 Blurry Spectrum Disorders 235 N.R. Swerdlow 5.6 Spectrum Disorders: Utilitarian Concepts or Utopian Fantasies? 238 J.W. Jefferson 5.7 Carving Nature at Its Joints: Different Approaches to the Obsessive-Compulsive Spectrum of Disorders 241 D.J. Stein 5.8 The Challenge of Deconvolving the Obsessive-Compulsive Disorder Spectrum into Its Component Diseases 244 M. George 5.9 Obsessive-Compulsive Spectrum Disorders: are Opposites Related? 246 R. Crino 5.10 The Spectrum of Obsessive-Compulsive-Related Disorders: State of the Art 249 D. Marazziti CHAPTER 6 COSTS OF OBSESSIVE-COMPULSIVE DISORDER 253 Costs of Obsessive-Compulsive Disorder: A Review 253 M. Knapp, J. Henderson and A. Patel x CONTENTS COMMENTARIES 6.1 Considering the Full Economic Burden 276 M.M. Weissman 6.2 The Economics of Obsessive-Compulsive Disorder: Achieving the Potential Benefit 278 M. Aveline 6.3 In Search of Data on Costs of Obsessive-Compulsive Disorder 281 G. Steketee 6.4 Obsessive Slowness in Creating a Cost-Effectiveness Evidence Base for Obsessive-Compulsive Disorder 283 G. Thornicroft 6.5 Evaluations of Treatments for Obsessive-Compulsive Disorder: the Need for Health Economics Input 286 P. McCrone 6.6 Obsessive-Compulsive Disorder: a Psychiatric Disorder in Economic No Man's Land 288 P. Tyrer 6.7 Not Expensive and Cheap to Treat: New Evidence Leads to Different Conclusions 290 G. Andrews 6.8 Economics of Obsessive-Compulsive Disorder: on Safe Grounds? 293 W. RoÈssler 6.9 Obsessive-Compulsive Disorder: the Hidden Costs of a Hidden Epidemic 295 L. Salvador-Carulla 6.10 Obsessive-Compulsive Disorder: an Underestimated Disorder 297 M.
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