Behaviour therapy for obsessive compulsive disorder in a 78-year-old woman.
OBJECTIVE: To describe a case of late onset obsessive compulsive disorder (OCD) and determine the impact of a behavioural intervention on OCD symptoms. DESIGN: A single case design was undertaken in which the severity of the patient's OCD symptoms was measured before and after treatment. SETTING: The intervention was undertaken in the patient's home. PATIENT: A 78-year-old woman with a history of depression who experienced sudden onset and rapid escalation of OCD following a domestic accident. INTERVENTION: A behavioural procedure involving continuous in vivo exposure and response prevention over an 8-hour period. MEASURES: The Y-BOCS self-rating scale (Yale Brown Obsessive Compulsive Scale) and clinical observation. RESULTS: Y-BOCS score improved from 35 prior to treatment to 12 post treatment (mean for OCD population = 25.1; SD = 6, Goodman et al., 1989). Improvement was maintained at 2 months follow-up (Y-BOCS = 11). Improvements in confusion and agitation were also observed. CONCLUSIONS: This case study supports the use of behavioural interventions for elderly patients suffering from OCD. Risk factors and treatment designs are discussed in view of the literature.