Table Of ContentPSYCHIATRY - THEORY, APPLICATIONS AND TREATMENTS
O -C
BSESSIVE OMPULSIVE
D
ISORDER
S , T
YMPTOMS HERAPY
C C
AND LINICAL HALLENGES
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P - T ,
SYCHIATRY HEORY
A T
PPLICATIONS AND REATMENTS
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PSYCHIATRY - THEORY, APPLICATIONS AND TREATMENTS
O -C
BSESSIVE OMPULSIVE
D
ISORDER
S , T
YMPTOMS HERAPY
C C
AND LINICAL HALLENGES
JEFFREY L. NELSON
EDITOR
Copyright © 2021 by Nova Science Publishers, Inc.
DOI: https://doi.org/10.52305/PLHB7934
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Library of Congress Cataloging-in-Publication Data
Names: Nelson, Jeffrey L., editor.
Title: Obsessive-compulsive disorder : symptoms, therapy and clinical
challenges / Jeffrey L. Nelson, editor.
Description: New York : Nova Science Publishers, [2022] | Series:
Psychiatry - theory, applications and treatments | Includes
bibliographical references and index. |
Identifiers: LCCN 2021052838 (print) | LCCN 2021052839 (ebook) | ISBN
9781685073107 (paperback) | ISBN 9781685073268 (adobe pdf)
Subjects: LCSH: Obsessive-compulsive disorder. | Obsessive-compulsive
disorder--Treatment.
Classification: LCC RC533 .O27285 2022 (print) | LCC RC533 (ebook) | DDC
616.85/227--dc23/eng/20211027
LC record available at https://lccn.loc.gov/2021052838
LC ebook record available at https://lccn.loc.gov/2021052839
Published by Nova Science Publishers, Inc. † New York
CONTENTS
Preface vii
Chapter 1 Obsessive-Compulsive Disorder:
A General Overview 1
Riccardo Santini, Antonella Mariano,
Federico Fiori Nastro, Martina Pelle,
Alberto Siracusano, Cinzia Niolu
and Flavia di Michele
Chapter 2 Relevant Mechanisms in Treating
Obsessive-Compulsive Disorder:
The Case for Domain-Specific Relevance
with Scrupulosity and Other Forms
of Obsessions and Compulsions 57
Dakota Mauzay
Chapter 3 Acute-Onset Subtypes of Pediatric Obsessive-
Compulsive Disorder: Pediatric Acute-Onset
Neuropsychiatric Syndrome and Pediatric
Autoimmune Neuropsychiatric Disorders
Associated with Streptococcal Infections 89
Canan Kuygun Karci
vi Contents
Chapter 4 The Effects of COVID-19 Pandemic
on Children and Adolescents
with Obsessive-Compulsive Disorder 111
Canan Kuygun Karci
Chapter 5 A Review of Considerations in Assessing
and Treating Religious-Themed Obsessions 125
Kelly N. Banneyer
Index 137
PREFACE
Obsessive-compulsive disorder (OCD), which is characterized by
distressing intrusive thoughts and repetitive, time-consuming, task-
oriented actions intended to counter these thoughts and reduce anxiety,
represents a serious psychiatric condition and cause of disability
worldwide. This book consists of five chapters that provide details on the
effects of OCD and strategies for reducing its negative impact. Chapter
one provides a general overview of OCD, including its neurochemical
basis and treatment approaches. Chapter two explores some of the
nuisances present in working with individuals with OCD within the
context of obsessive and compulsive content that may require additive
elements to be considered in treatment. Chapter three discusses the
diagnostic criteria, clinical aspects, and current treatment approaches of
pediatric acute-onset neuropsychiatric syndrome and pediatric
autoimmune neuropsychiatric disorders associated with streptococcal
infections. Chapter four describes the effects of the COVID-19 pandemic
on children and adolescents with OCD. Lastly, chapter five explains the
role that religion takes in certain presentations of OCD and informs
clinicians how to differentiate between standard religious practices and
compulsive behaviors.
Chapter 1 - Obsessive compulsive disorder (OCD) is a serious
multifactorial psychiatric illness with a lifetime prevalence of 2-3%. It is
viii Jeffrey L. Nelson
characterized by distressing intrusive thoughts (obsessions), and task-
oriented repetitive, time-consuming actions (compulsions) planned to
contrast these thoughts and decrease the amount of anxiety. Typical
compulsive behaviors include excessive hand-washing, repetitive
checking, and concern for order and symmetry. OCD begins in late
adolescence or early adulthood, although also children can be affected by
an autoimmune OCD syndrome (PANDAS). OCD presents often in
comorbidity with other psychiatric disorders, such as anxiety disorders,
major depression, impulse control disorders and attention deficit
disorders. A substantial risk of suicide in OCD patients is now well
recognized. Therefore, the burden of disease is very high and OCD
represents a leading cause of disability. The pathophysiology of OCD is
extremely complex and heterogeneous, a dysfunction in the cortico-
striatal-thalamo-cortical circuit seems to be the core. Recent hypotheses
placing OCD in the context of impulsive control disorders in a trans-
diagnostic fashion that includes basal impulse dysregulation, suggest an
impaired reward and punishment processing with attenuated dopamine
release in the ventral striatum. Moreover, a dysfunction in the
glutamatergic neurotransmission, as well as neuroimmune abnormalities
might be involved in the pathophysiology of this disorder. Due to the
heterogeneity of OCD neurobiology, assessing the quantitative EEG of
OCD patients could be useful before deciding about treatment strategy
and for predicting treatment response. Treatment approaches range from
the use of medications to cognitive behavioral therapy, non-invasive
brain stimulation (TMS), to surgery. The use of antidepressants, such as
tricyclics or serotonin reuptake inhibitors, is based on the involvement of
the serotonergic system and the reduction of the anxiety rate in OCD.
Atypical antipsychotics represent another class of medications used in the
management of OCD symptoms, often in add-on with antidepressants.
The alterations in signaling and metabolism of glutamate suggest the use
of glutamate-modulating agents. Nutraceutics with anti-inflammatory,
neuromodulatory and neuroprotective activity may represent a
complementary useful treatment for OCD, considering the evidence-
based problem of treatment resistance. Nutraceutics must be also
