Does OCD Require Hospitalization for Effective Treatment?

Treatment Options for OCD

Female depressed patient sitting on the bed in a hospital ward
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In most cases, no. The majority of people with obsessive-compulsive disorder (OCD) can be treated very effectively on an outpatient basis by a variety of qualified mental healthcare service providers using either psychotherapy or medication, or a combination thereof.

Medications

The most common medications used to treat OCD are selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine hydrochloride) and Zoloft {sertraline); serotonin and norepinephrine reuptake inhibitors (SNRIs) like Celexa (citalopram), Lexapro (escitalopram) and Effexor (venlafaxine); and a tricyclic antidepressant known as Anafranil (clomipramine).

Psychotherapy

Exposure therapy and cognitive behavioral therapy (CBT) have been shown to be particularly helpful in the treatment of OCD symptoms.

Repetitive Transcranial Magnetic Stimulation

Another potential treatment option is repetitive transcranial magnetic stimulation (rTMS), which involves placing a magnetic coil on the skull and using electricity to pulse through the device to targeted areas of the brain. This treatment has varied results, but because it is non-invasive and has few side effects, it can be a good option for people with OCD who are not finding relief from conventional methods.

When In-Patient Treatment is Necessary

Participation in intensive in-patient treatment programs is reserved for only the most serious cases of OCD. Fortunately, these severe cases comprise the minority of OCD patients. Given the cost and commitment required, intensive in-patient programs are often viewed as a last resort when other treatments have failed.

In cases requiring hospitalization, the person is experiencing OCD symptoms severe enough to seriously impair their ability to function at work and at home. It is not uncommon for candidates for intensive OCD in-patient programs to have been unemployed for many years and to have serious impairments in their relationships with friends and family.

In especially severe cases, the person may not have left their home for days, weeks, months (or longer). Patients requiring in-patient treatment for severe symptoms may spend almost all day engaged in rituals or compulsions.

Hospitalization Options

Even in cases where patients need a higher level of treatment, there are options such as day programs, intensive outpatient programs, partial hospital programs, and residential programs. Full hospitalization is usually only implemented when patients cannot take care of themselves or they are dangerous to themselves or others.

While the vast majority of hospitalizations for OCD are voluntary, in cases where the person’s symptoms are so severe that they are a danger to themselves or others, for instance, children who are being neglected because of the parents' OCD symptoms, they may be hospitalized involuntarily. Suicidal thoughts associated with depression caused by severe and unrelenting OCD symptoms are also a common reason for hospitalization.

Laser Surgery

As a last resort, the FDA has approved laser surgery to treat patients with severe, treatment-resistant OCD. This procedure targets and burns away parts of the brain in the region known as the anterior cingulate cortex. Early studies have shown this procedure to be extremely effective for about half the people who have undergone treatment.

Sources

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

http://www.cnn.com/2015/07/21/health/ocd-laser-surgery/

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