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A brief introduction to ocd obsessive compulsive disorder

Although distinct disorders, OCD and BDD share a number of common features and there is a high degree of similarity between the treatments for the two conditions. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, people with OCD, a carer and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with OCD and BDD while also emphasising the importance of the experience of care for people with OCD, BDD, and carers.

An Introduction to Obsessive-Compulsive Disorder

This guideline addresses aspects of service provision, psychological and pharmacological approaches for those with OCD and BDD from the age of 8 upwards. Although the evidence base is rapidly expanding, there are a number of major gaps and future revisions of this guideline will incorporate new scientific evidence as it develops. The guideline makes a number of research recommendations specifically to address these gaps in the evidence base.

In the meantime, we hope that the guideline will assist clinicians, people with these disorders and their carers by identifying the merits of particular treatment approaches where the evidence from research and clinical experience exists. What are clinical practice guidelines?

1.1. NATIONAL GUIDELINES

They are derived from the best available research evidence, using predetermined and systematic methods to identify and evaluate the evidence relating to the specific condition in question. Where evidence is lacking, the guidelines incorporate statements and recommendations based upon the consensus statements developed by the Guideline Development Group GDG. Clinical guidelines are intended to improve the process and outcomes of healthcare in a number of different ways.

Provide up-to-date evidence-based recommendations for the management of conditions and disorders by healthcare professionals Be used as the basis to set standards to assess the practice of healthcare professionals Form the basis for education and training of healthcare professionals Assist patients and carers in making informed decisions about their treatment and care Improve communication between healthcare professionals, patients and carers Help identify priority areas for further research.

Uses and limitations of clinical guidelines Guidelines are not a substitute for professional knowledge and clinical judgement. They can be limited in their usefulness and applicability by a number of different factors: Appraisal of Guidelines for Research and Evaluation Instrument; www.

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However, there will always be some people and situations for which clinical guideline recommendations are not readily applicable. In addition to the clinical evidence, cost- effectiveness information, where available, is taken into account in the generation of statements and recommendations of the clinical a brief introduction to ocd obsessive compulsive disorder.

While national guidelines are concerned with clinical and cost effectiveness, issues of affordability and implementation costs are to be determined by the NHS. In using guidelines, it is important to remember that the absence of empirical evidence for the effectiveness of a particular intervention is not the same as evidence for ineffectiveness.

In addition, of particular relevance in mental health, evidence-based treatments are often delivered within the context of an overall treatment programme including a range of activities, the purpose of which may be to help engage the person with OCDand to provide an appropriate context for the delivery of specific interventions. It is important to maintain and enhance the service context in which these interventions are delivered; otherwise the specific benefits of effective interventions will be lost.

Indeed, the importance of organising care in order to support and encourage a good therapeutic relationship is at times as important as the specific treatments offered. Why develop national guidelines? The National Institute for Health and Clinical Excellence NICE was established as a Special Health Authority for England and Wales in 1999, with a remit to provide a single source of authoritative and reliable guidance for patients, professionals and the public.

NICE guidance aims to improve standards of care, to diminish unacceptable variations in the provision and quality of care across the NHS and to ensure that the health service is patient-centred.

All guidance is developed in a transparent and collaborative manner using the best available evidence and involving all relevant stakeholders. NICE generates guidance in a number of different ways, two of which are relevant here. First, national guidance is produced by the Technology Appraisal Committee to give robust advice about a particular treatment, intervention, procedure or other health technology.

Second, NICE commissions the production of national clinical practice guidelines focused upon the overall treatment and management of a specific condition.

To enable this latter development, NICE has established seven National Collaborating Centres in conjunction with a range of professional organisations involved in healthcare.

  1. For further information about obsessive-compulsive disorder which is a type of anxiety disorder , please contact.
  2. If the patient tries to overcome these compulsions it increases the anxiety and distress. Where meta-analyses were conducted, information is given about both the interventions included and the studies considered for review.
  3. Specifically, according to the NIMH. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary.

The NCCMH is a collaboration of the professional organisations involved in the field of mental health, national patient and carer organisations, a number of academic institutions and NICE.

From national guidelines to local protocols Once a national guideline has been published and disseminated, local healthcare groups will be expected to produce a plan and identify resources for implementation, along with appropriate timetables. Subsequently, a multidisciplinary group involving commissioners of healthcare, primary care and specialist mental health professionals, patients and carers should undertake the translation of the implementation plan into local protocols taking into account both the recommendations set out in this guideline and the priorities set in the National Service Framework for Mental Health and related documentation.

What is OCD?

The nature and pace of the local plan will reflect local healthcare needs and the nature of existing services; full implementation may take a considerable time, especially where substantial training needs are identified.

Auditing the implementation of guidelines This guideline identifies key areas of clinical practice and service delivery for local and national audit. Although the generation of audit standards is an important and necessary step in the implementation of this guidance, a more broadly based implementation strategy will be developed. Nevertheless, it should be noted that the Healthcare Commission will monitor the extent to which Primary Care Trusts PCTstrusts responsible for mental health and social care and Health Authorities have implemented these guidelines.

Who has developed this guideline? The GDG included people with OCD and a carer, and professionals from psychiatry, clinical psychology, child psychology, nursing, and general practice. Staff from the NCCMH provided leadership and support throughout the process of guideline development, undertaking systematic searches, information retrieval, appraisal and systematic review of the evidence.

The GDG met a total of 21 times throughout the process of guideline development. The GDG met as a whole, but key topics were led by a national expert in the relevant topic. The group oversaw the production and synthesis of research evidence before presentation.

All statements and recommendations in this guideline have been generated and agreed by the whole GDG. For whom is this guideline intended? This guideline will be relevant for people with a diagnosis of obsessive-compulsive disorder OCD or body dysmorphic disorder BDD aged 8 years and over.

  • Finally, recommendations related to each topic are presented at the end of each chapter;
  • All statements and recommendations in this guideline have been generated and agreed by the whole GDG;
  • They are derived from the best available research evidence, using predetermined and systematic methods to identify and evaluate the evidence relating to the specific condition in question;
  • Clinical summaries are then used to summarise the evidence presented;
  • According to the National Institute of Mental Health NIMH , "Persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly, are common.

The guideline covers the care provided by primary, community, secondary, tertiary, and other healthcare professionals who have direct contact with, and make decisions concerning the care of adults, children and young people with OCD and BDD.

The guideline will also be relevant to the work, but will not cover the practice, of those in: The guideline recognises the role of both in the treatment and support of people with these conditions.

  1. It is important to know more about mental illness, to improve the treatment and acceptance of mental illness in our society.
  2. It is probably a complex combination of genetic, biological, psychological and social factors which go to make up what we label "OCD.
  3. First, national guidance is produced by the Technology Appraisal Committee to give robust advice about a particular treatment, intervention, procedure or other health technology.

Specifically, it aims to: Integrate the above to provide best practice advice on the care of individuals with a diagnosis of OCD or BDD throughout the course of the disorder. Promote the implementation of best clinical practice through the development of recommendations tailored to the requirements of the NHS in England and Wales. The structure of this guideline The guideline is divided into chapters, each covering a set of related topics.

The third chapter provides testimonies regarding the experience of people with OCD and BDD and their families and carers. The fourth chapter details the methods used to develop the guideline. Chapters 5 to 8 provide the evidence that underpins the recommendations and Chapter 9 covers the use of health service resources. The final chapter provides a summary of the recommendations. Each evidence chapter begins with a general introduction to the topic that sets the recommendations in context.

Depending on the nature of the evidence, narrative reviews or meta-analyses were conducted. Therefore, the structure of the chapters varies. Where appropriate, details about current practice, the evidence base and any research limitations are provided. Where meta-analyses were conducted, information is given about both the interventions included and the studies considered for review.

This is followed by selected clinical evidence statements a complete list of evidence statements can be found in Appendix 18. Clinical summaries are then used to summarise the evidence presented.

Finally, recommendations related to each topic are presented at the end of each chapter. Where meta-analyses were conducted, the data are presented using forest plots in Appendix 17 see Text Box 1 for details. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Enquiries in this regard should be directed to the British Psychological Society.