scholarly journals Clinical Challenges in Pedophilia-Themed Obsessive-Compulsive Disorder

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Carla Ferreira ◽  
Liliana Ferreira ◽  
Samuel Pombo ◽  
Rui Xavier Vieira

In obsessive-compulsive disorder, pedophilia-themed obsessions-distressing intrusive thoughts about being sexually attracted to, or sexually abusing, children-are the most distressing for patients and the most misdiagnosed among healthcare professionals. Our aim is to present a case report highlighting the role stigma plays in delaying treatment, the clinical challenges in the diagnosis, and in the treatment of pedophilia-themed obsessive-compulsive disorder, in order to address the lack of literature on the subject. The case concerns a 33-year-old man with suicidal thoughts associated with the unbearable suffering caused by pedophilia-themed obsessions he had been having over the previous decade, without ever asking for help. This situation was highly disabling, leaving him mostly isolated in his bedroom. After the differential diagnosis was made, a treatment plan combining pharmacological and cognitive-behavioural therapy was implemented. After 18 months he showed a degree of remission that made it possible for him to apply for a job.

Author(s):  
Paul M. Salkovskis ◽  
Joan Kirk

Chapter 8 explores obsessive-compulsive disorder (OCD). It first outlines the nature of OCD, its prevalence, the development of current treatments, the behavioural theory of OCD and behaviour therapy in practice, deficit theories and cognitive factors, cognitive behavioural therapy (CBT) for OCD, experimental studies of normal intrusive thoughts, distorted thinking and negative appraisals, treatment implications of the cognitive behavioural theory, and strategies in the treatment of OCD.


2017 ◽  
Vol 41 (S1) ◽  
pp. S643-S644
Author(s):  
J. Vyskocilova ◽  
J. Prasko ◽  
J. Sipek ◽  
M. Slepecky

BackgroundThe objective of investigation was to determine whether patients with obsessive-compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioural therapy (CBT) lasting six weeks and whether it is possible to predict treatment outcome using clinical and selected psychological characteristics.MethodFrom 66 OCD patients fifty-seven completed program. The diagnosis was confirmed using the structured mini international neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), objective and subjective forms of the Clinical Global Impression (CGI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), dissociative experiences scale, 20-item Somatoform dissociation questionnaire and sheehan disability scale before treatment, and with subjective Y-BOCS, objective and subjective CGI, BAI and BDI at the end of treatment. Patients were treated with antidepressants and daily intensive group CBT for six weeks.ResultsDuring 6-week intensive CBT program in combination with pharmacotherapy, there was significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decreased scores of scales assessing severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who (a) showed fewer OCD themes in symptomatology, (b) showed higher level of somatoform dissociation, (c) had poor insight and (d) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who (a) had good insight, (b) had a lower initial level of anxiety and (c) had no comorbid depressive disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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