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Risk assessment and management in obsessive–compulsive disorder

  • David Veale, Mark Freeston, Georgina Krebs, Isobel Heyman and Paul Salkovskis...
Summary

Some people with obsessive–compulsive disorder (OCD) experience recurrent intrusive sexual, aggressive or death-related thoughts and as a result may be subjected to lengthy or inappropriate risk assessments. These apparent ‘primary’ risks can be dealt with relatively easily through a careful understanding of the disorder's phenomenology. However, there are other, less obvious ‘secondary’ risks, which require more careful consideration. This article discusses the differentiation of intrusive thoughts and urges in people with OCD from those experienced by sexual or violent offenders; assessing the risk of self-harm and suicide; discussing the nature of repugnant obsessions with a patient; assessing risk of harm and violence to the dependents and family living with someone with the disorder; and assessing the lack of insight and the use of the Mental Health Act. Issues specifically related to children and young people with OCD are also highlighted.

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Copyright
Corresponding author
Dr David Veale, Centre for Anxiety Disorders and Trauma, Maudsley Hospital, 99 Denmark Hill, London SE5 8AF, UK. Email: David.Veale@iop.kcl.ac.uk
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Declaration of Interest

None.

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References
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Baron-Cohen, S (2001) Theory of mind and autism: a review. In International Review of Research in Mental Retardation: Autism (ed Glidden, LM) 169–84. Academic Press.
Dimidjian, S, Hollon, SD, Dobson, KS et al (2006) Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology; 74: 658–70.
Freeman, JB, Leonard, HL (2000) Sexual obsessions in obsessive-compulsive disorder. Journal of American Academic Child and Adolescent Psychiatry; 39: 141–2.
Geller, DA (2006) Obsessive–compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics of North America; 29: 353–70.
Gordon, H, Grubin, D (2004) Psychiatric aspects of the assessment and treatment of sex offenders. Advances in Psychiatric Treatment; 10: 7380.
Healy, N, Fitzpatrick, C, Fitzgerald, E (1991) Clinical note: childhood neurotic disorders with a sexual content need not imply child sexual abuse. Journal of Child Psychology and Psychiatry; 32: 857–63.
Hoehn-Saric, R, Ninan, P, Black, DW et al (2000) Multicenter double-blind comparison of sertraline and desipramine for concurrent obsessive–compulsive and major depressive disorders. Archives of General Psychiatry; 57: 7682.
Maina, G, Albert, U, Bogetto, F et al (1999) Recent life events and obsessive–compulsive disorder (OCD): the role of pregnancy/delivery. Psychiatry Research; 89: 4958.
Mancini, C, van Ameringen, M, Farvolden, P (2002) Does SSRI augmentation with antidepressants that influence noradrenergic function resolve depression in obsessive–compulsive disorder? Journal of Affective Disorders; 68: 5965.
Marshall, WL, Langton, CM (2005) Unwanted thoughts and fantasies experienced by sexual offenders. In Intrusive Thoughts in Clinical Disorders: Theory, Research, and Treatment (ed Clark, DA) 199225. Guilford Press.
National Collaborating Centre for Mental Health (2005) Obsessive–Compulsive Disorder: Core Interventions in the Treatment of Obsessive–Compulsive Disorder and Body Dysmorphic Disorder. Clinical Guideline 31. NICE.
Rachman, SJ, De Silva, P (1978) Abnormal and normal obsessions. Behaviour Research and Therapy; 16: 233–48.
Rachman, S (1997) A cognitive theory of obsessions. Behavior Research and Therapy; 35: 793802.
Salkovskis, P (1985) Obsessional–compulsive problems: a cognitive–behavioural analysis. Behaviour Research and Therapy; 23: 571–83.
Salkovskis, P, Kirk, J (2008) Obsessional disorders. In Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide (eds Hawton, K, Salkovskis, PM, Kirk, J et al): 129–68. Oxford University Press.
Sichel, DA, Choen, LS, Dimmock, JA et al (1993) Postpartum obsessive–compulsive disorder: a case series. Journal of Clinical Psychiatry; 54: 156–9.
Storch, EA, Geffken, GR, Merlo, LJ et al (2007) Family accommodation in pediatric obsessive–compulsive disorder. Journal of Clinical Child and Adolescent Psychology; 36: 207–16.
Torres, A, Prince, M, Bebbington, P et al (2006) Obsessive compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric morbidity study of 2000. American Journal of Psychiatry; 163: 1978–85.
Veale, D (2002) Over-valued ideas: a conceptual analysis. Behaviour Research and Therapy; 40: 383400.
Veale, D (2007) Cognitive–behavioural therapy for obsessive–compulsive disorder. Advances in Psychiatric Treatment; 13: 438–46.
Veale, D (2008) Behavioural activation for depression. Advances in Psychiatric Treatment; 14: 2936.
Veale, D, Willson, R (2005) Overcoming Obsessive Compulsive Disorder. Robinson.
Volz, C, Heyman, I (2007) Transformation obsession in young people with obsessive–compulsive disorder (OCD). Journal of the American Academy of Child and Adolescent Psychiatry; 46: 766–72.
Warwick, HM, Salkovskis, PM (1990) Unwanted erections in obsessive–compulsive disorder. British Journal of Psychiatry; 157: 919–21.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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Risk assessment and management in obsessive–compulsive disorder

  • David Veale, Mark Freeston, Georgina Krebs, Isobel Heyman and Paul Salkovskis...
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