Obsessieve-compulsieve stoornis: praktische handvatten voor de huisarts

Abstract

Obsessive-compulsive disorder: practical tools for the GP Obsessive-compulsive disorder (OCD) is a relatively prevalent complex psychiatric disorder associated with significant impairment and distress. OCD remains often undetected because of the reluctance of patients to discuss their symptoms and the lack of recognizing OCD symptoms by the physicians. The general practitioner (GP) should be able to recognize OCD symptoms since a chronic course is associated with poor prognosis. The GP has a key role to play in the recognition, diagnosis, treatment and referral of patients with OCD. An early detection in all patients at higher risk of OCD provides timely access to evidence-based therapies. Psychoeducation about the disorder is an important step for improving recovery. Treatment of choice is cognitive behavioral therapy with exposure and response prevention combined with or without a selective serotonin reuptake inhibitor (SSRI). The required medication doses are often higher and duration to response longer than those for depression. In- and exclusion criteria for deep brain stimulation (DBS) are carefully defined in Belgium by the committee peer review OCD for therapy refractory OCD. The GP has also a critical role in the follow-up of patients with OCD over time by monitoring the relapse risk, therapy compliance and side effects of the medication.