New partnership may help treat obsessive-compulsive disorder

Clinicians will now have greater access to the most current
training on obsessive-compulsive disorder, thanks to a partnership between two
mental-health organizations.

On Tuesday, Massachusetts General Hospital’s Psychiatry
Academy and the International OCD Foundation announced that they will develop
new training programs to help clinicians assess and treat OCD and related
disorders, which can be debilitating for some people.

According to the Anxiety and Depression
Association of America, obsessive-compulsive disorder affects 2.2 million
Americans, or about 1 percent of the population. Some studies have found prevalence
rates up to 2 percent, but those results have been called into question based
on their methodology.

“OCD is one of those conditions that has
gotten so overused in general conversation that it’s important to distinguish
the disorder from its sometimes common casual use,” said Dr. Matthew Rudorfer,
psychiatrist and director of the National Institute of Mental Health’s Somatic
Treatments Program. Rudorfer is not involved in the development of the training
“People will joke,‘you’re so OCD,

” Rudorfer
said. “It’s perfectly okay if you like to line up your shoes in your closet. Now, on the other hand, if you spend all day rearranging your shoes and you
refuse to leave your house because they don’t look perfect yet, that’s
something else.”
The past 30 years have seen a major
evolution in the way OCD is diagnosed and treated. Before the 1980s, OCD was
considered rare and the primary treatment was psychoanalysis.


“The psychoanalytic theories were very
interesting hypothetically, but were never really able to be translated into
useful treatment for OCD,” Rudorfer said.


A revolution came in the form of new medications,
specifically clomipramine, an anti-depressant that inhibited the re-uptake of serotonin.
The brain chemical serotonin maintains mood balance and transmits impulses between
nerve cells. The control of serotonin levels has been shown to help people with
depression and with anxiety disorders like OCD.


Clomipramine and, later, selective serotonin
re-uptake inhibitors, commonly known as SSRIs, proved effective in treating
most people with OCD.


“The history of the field Is that it was
really only well into the second half of the 20th century that we really had
effective medications, and that really changed everything,” Rudorfer said. “As
we’ve found with many mental disorders, the combination of medication and
behavior therapy is very powerful. They work very well together and that’s
probably the treatment of choice for most people.”


Behavior therapy works by helping patients
recognize problem behaviors and develop new habits.

The IOCDF has been running a behavior-therapy training institute for more than 20 years, but the demand is ever-increasing.


the type of therapy used for OCD is not the type of therapy that many professionals
learn in graduate school,” said Dr.
Jeff Szymanski, a clinical psychologist and executive director of the IOCDF. “So, unfortunately for many individuals
with OCD, mental-health training is still lagging behind. A primary goal of
this partnership is to help disseminate this information and fill that training


Szymanski has partnered with Dr. Sabine
Wilhelm, who is chief of psychology and director of the OCD program at Massachusetts General,
as well as vice-chair of the IOCDF’s scientific
and clinical advisory board.

Together, they are developing interactive online
courses comprised of videos, self-assessments and moderated discussion boards.


Mental-health and medical professionals
will use the mobile-friendly, on-demand content to develop a personalized
cognitive behavioral model for patients with OCD, apply skills to treat the
different OCD system sub-types and manage treatment-interfering behaviors.


The IOCDF and

Massachusetts General

plan to develop more online
courses for OCD-related disorders, such as body dimorphic disorder, hoarding
disorder and bodily-focused repetitive disorders.


“The fact that we have good treatments now
means that it’s recognized more. In terms of training to have clinicians be
aware of the latest is certainly only a good thing,” Rudorfer said. “We know a
lot more than we used to but there’s still plenty of dots to connect. I think
that keeping up with the latest is only a good thing.”


The courses are currently in development. A
formal launch date has not been announced.