Am J Psychiatry 1981; 138:584-592
Copyright © 1981 by American Psychiatric Association
Review of behavioral psychotherapy, I: Obsessive-compulsive disorders
IM Marks
Obsessive-compulsive ritualizers have maintained their improvement after
exposure in vivo for up to 3 years' follow-up in the United States,
Britain, Greece, and Australia. Unlike exposure in vivo, relaxation is of
little value. Early gains in treatment predict long- term outcome. Exposure
therapy is usually on an outpatient basis and takes 1-30 sessions.
Self-exposure homework is critical. Sessions at home are also required,
together with relatives cooperating as exposure cotherapists. Some patients
can treat themselves almost unaided, while others need extensive
assistance. Clomipramine is helpful for ritualizers with coexisting
depression, but depression tends to recur when clomipramine therapy is
stopped.
