[Approach to a schizophrenic patient with obsessive behavior].
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Morbid jealousy can occasionally be indistinguishable from obsessive-compulsive neurosis and then be partially amenable to broad-spectrum behavioural treatment. This can involve the partner and includes (a) methods to reduce jealousy and (b) other methods where appropriate, such as social skills training, and sex and marital therapy. This pilot study describes such treatment of four jealous out-patients. Rituals improved in three patients but ruminations in only one. Of three patients who were depressed at the start of treatment, two improved in rituals and in mood. The patient who failed was poorly motivated and did not comply with treatment.
During the last two decades, effective psychotherapeutic interventions have been developed and proven successful in treating patients with Obsessive-Compulsive Disorder (OCD). Behavior therapy, using exposure to anxiety-evoking stimuli and response prevention directed toward rituals, provides lasting benefit for most patients who engage in and comply with treatment. A recent study indicated that, for certain OCD patients, these interventions could be applied successfully in a group therapy context. This article describes the general procedures used in this study to treat obsessive-compulsives with exposure and response prevention in a group context.
A sex-linked familial neurological disease consisting of cerebral palsy, mental retardation, choreoathetosis, and compulsive aggressive behavior is associated with a loss of an enzyme that participates in purine metabolism, namely, hypoxanthine-guanine phosphoribosyltransferase. The production of excessive uric acid in this disorder implies that the enzyme is involved in the normal regulation of purine biosynthesis. This is the first example of a relation between a specific enzyme defect and abnormal compulsive behavior. It is also the first enzyme defect in purine metabolism demonstrated in a neurological disease.
This paper presents a family therapy approach to the treatment of an obsessive-compulsive child. Psychodynamic, behavioral and family therapy approaches to the etiology and treatment of this dysfunction are described briefly, and a detailed case report of a 15-session treatment utilizing behavioral interventions designed to change the family context is presented. Various procedures for dealing with the obsessive-compulsive behavior have been reported in the literature, including eliminating it directly by interruption or ordeal and modifying it. In this case, the author proceeded by ignoring the compulsive behaviors and concentrating on more functional ones using a paradoxical charting intervention. At one-year follow-up, the child was symptom free. Relationship factors, technical interventions, and stylistic aspects of the therapy are discussed, and the importance of rapid symptom alleviation in these children is underscored.
BACKGROUND: We sought to determine in a new patient sample whether symptomatic improvement in obsessive-compulsive disorder treated with behavior modification is accompanied by significant changes in glucose metabolic rates in the caudate nucleus, measured with positron emission tomography, as seen in a previous study. Second, by combining samples from this and the previous study, we also examined whether there were pathologic correlational relationships among brain activity in the orbital cortex, caudate nucleus, and thalamus that obtained before behavioral treatment of obsessive-compulsive disorder, but that decreased significantly with symptom improvement. METHODS: Nine patients with obsessive-compulsive disorder were studied with positron emission tomography before and after 10 weeks of structured exposure and response prevention behavioral and cognitive treatment. Results were analyzed both alone and combined with those from nine similar subjects from the previous study. RESULTS: Behavior therapy responders had significant (P < .05) bilateral decreases in caudate glucose metabolic rates that were greater than those seen in poor responders to treatment. Before treatment, there were significant correlations of brain activity between the orbital gyri and the head of the caudate nucleus and the orbital gyri and the thalamus on the right. These correlations decreased significantly after effective treatment. CONCLUSIONS: These results replicate and extend previous findings of changes in caudate nucleus function with behavior therapy for obsessive-compulsive disorder. A prefrontal cortico-striato-thalamic brain system is implicated in mediation of symptoms of obsessive-compulsive disorder.
A 38-year-old women with bilateral thalamic infarctions had a severe memory disorder, severe apathy, and a compulsive tendency to assume a sleeping position. Bromocriptine improved the apathy and the disinhibited pre-sleep behavior.
OBJECTIVE: To examine the full spectrum of psychiatric comorbidity in juvenile obsessive-compulsive disorder (OCD) in a naturalistic manner when no exclusionary criteria are used for sample selection. METHOD: Consecutive referrals to a specialized pediatric OCD clinic were evaluated by means of structured diagnostic interviews and rating scales. No exclusionary criteria were used for sample selection. Findings were compared with those of previously published reports of juvenile OCD. RESULTS: Compared with previous studies, our sample of juveniles with OCD had high rates of comorbidity not only with tic, mood, and anxiety disorders but also with disruptive behavior disorders. CONCLUSIONS: Our findings indicate that in the naturalistic setting, juvenile OCD is heavily comorbid with both internalizing and externalizing disorders. The presence of such a complex comorbid state has important clinical and research implications and stresses the relevance of limiting exclusionary criteria in studies of juvenile OCD.
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This report describes the behavioral treatment of psychogenic polydipsia in an autistic, severely mentally retarded woman who had a history of self-induced water intoxication. Treatment emphasized the use of edibles and reductions in activity demands to reward water refusal. Employing this procedure, paraprofessional staff normalized the client's water consumption, and thereby prevented further episodes of potentially-fatal water intoxication.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.