Forming part of the World Psychiatric Association's Current Science and Clinical Practice series, this book has brought together a number of experts who discuss assessment and treatment, with clinical and research spotlights and a brief resume examining possible future directions of treatment and research in obsessive-compulsive disorder (OCD).
It is mooted that the current work on genetics, brain imaging and a sophisticated understanding of neurotransmitters will result in a second major revolution in the understanding and treatment of OCD. The first revolution occurred in the 1970s when the condition was discovered to be common and when successful drug and graded exposure treatments were described.
The book is timely. Although OCD is a very common disorder which causes much suffering worldwide, services for this condition are patchy and often overlooked. Despite the chance of making radical changes to the quality of life of those who are affected, they are often dismissed by mental healthcare planners as ‘the worried well’. This is far from the truth and OCD has been ranked among the top ten causes of health disability worldwide. Most individuals with OCD suffer in silence and do not cause a public outcry.
The book has brought together an impressive list of experts in the field. They come from the USA, Europe, Israel and South Africa. As may be expected in a book written in English, there is a predominance of US and British authors. Nevertheless, covering both adult and childhood OCD, this is an extremely useful book for anyone who wishes to extend their knowledge and develop services for OCD. As well as presenting the science behind OCD, the outcomes of various therapeutic interventions are also examined.
My criticism of the book is that, as a multi-author work, it is in parts highly repetitive. For example, almost every chapter includes a description of the Yale-Brown Obsessive Compulsive Scale. This may be useful for the reader who uses the book as a reference work, but it is tedious for anyone reading it from beginning to end. Another criticism is that whereas a wealth of neuropsychiatric research is presented, cognitive-behavioural therapy (CBT) is rather sparsely covered. There is a relatively short chapter on psychological treatments but the general role of CBT, such as in treatment-refractory OCD, is not fully described.
Despite my reservations I feel this is a useful addition to the literature and would recommend it to all adult and child psychiatrists who may wonder how to treat these patients.
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