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Obsessive-compulsive disorder can really interfere with everyday activities and make it almost impossible to live a normal life. But there are treatments that can help to get it under control: particularly cognitive behavioral therapy, but medication too.People with obsessive-compulsive behavior (OCD) are haunted by constant repetitive thoughts or feel compelled to do things that they realize are pointless and don't want to do. Some are so afraid of germs that they constantly wash their hands. Others might check whether they have really turned off the oven over and over again, or can't stop constantly counting to 20.These kinds of compulsive thoughts and behaviors may seem exaggerated or strange. But they help people with OCD to feel calm for a while. Although they themselves almost always realize that their behavior is causing problems, it is difficult for them to stop for good on their own. When they try to suppress these urges, people with OCD may tense up or feel frightened. Psychological treatment and medications can help to manage this kind of behavior.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 19, 2017

The onset of obsessivecompulsive disorder often occurs in childhood and adolescence. Paediatric OCD can be an extremely debilitating disorder, resulting in high levels of distress, impairment and disruption of psychosocial development. It also has a considerable impact on other family members. While there is evidence that medication can reduce symptoms, behavioural and cognitive‐behavioural therapy (BT/CBT) are often proposed as acceptable alternative treatments. These therapies include assisting the child to better tolerate the anxiety‐provoking situations and thoughts without the use of compulsive behaviour to manage their anxiety, psycho‐educationabout anxiety and OCD; cognitive therapy in which the child is helped to learn to identify and challenge unhelpful ways of thinking; and parental support.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 18, 2006

Transcranial magnetic stimulation was introduced as neurophysiological technique in 1985 when Anthony Barker and his team developed a compact machine that permitted a non‐invasive stimulation of the cerebral cortex. In addition it has been suggested that TMS could have therapeutic potential. Its' capability for excitation or inhibition of cortical areas in a non‐invasive way represents a remarkable advance in neuroscience researches. Some studies have evaluated the therapeutic effects of repetitive TMS in controlled studies on patients with obsessivecompulsive disorder observing some changes in their behaviour in terms of compulsive urges or improvements in mood. This review has evaluated the current evidence for TMS as a therapeutic treatment for obsessivecompulsive disorder (OCD). There is a lack of evidence for the effect of TMS in the treatment of OCD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 22, 2003

This review found some trials comparing the effects of adding second‐generation antipsychotic drugs or placebo to antidepressants in obsessive compulsive disorder. There were only 11 trials on three second‐generation antipsychotic drugs (olanzapine, quetiapine and risperidone). While not much can be said about olanzapine, quetiapine and risperidone showed some efficacy benefit, but also adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 8, 2010

People with obsessive-compulsive disorder may constantly wash their hands because they are afraid of germs, or may not be able to stop counting to 20. The compulsion can gradually come to dominate their life. But there are treatments that help to get this condition under control.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 19, 2017

Obsessive compulsive disorder (OCD) is a chronic and disabling anxiety disorder characterised by recurrent obsessions, such as persistent thoughts, impulses or mental images, that promote anxiety, together with compulsions, such as repetitive behaviours or mental acts, that are performed in response to the obsessions. Currently the most commonly used therapies for OCD are pharmacological therapies, followed by psychotherapies, particularly cognitive behavioural approaches. We reviewed studies that compared psychological interventions to treatment as usual groups who either received no treatment, or were on a waiting list for treatment or received usual care. We found eight studies, which together suggested that cognitive and/or behavioural treatments were better than treatment as usual conditions at reducing clinical symptoms. Baseline OCD severity and depressive symptom level predicted the degree of response. However, the conclusions were based on a small number of randomised controlled trials with small sample sizes. There were no trials of other forms of psychological treatment such as psychodynamic therapy and client‐centred therapy, and a lack of available evidence for the long‐term effectiveness of psychological treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 18, 2007

Obsessive compulsive disorder (OCD) is a common and disabling disorder, which frequently follows a chronic course. It is characterised by intrusive thoughts of imagined harm, which are difficult to dispel, and ritualistic behaviour such as repetitive washing of hands and repetitive checking for risk of harm. Individual randomised controlled trials have demonstrated that antidepressants are effective for OCD. This review summarises all the available evidence for one class of antidepressant drugs, the selective serotonin re‐uptake inhibitors (SSRIs) (including citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline) compared to placebo in the treatment of OCD in adults. The review included 17 studies (3097 participants), and showed that SSRIs were effective in reducing the symptoms of OCD. Based on 13 studies (2697 participants), the review showed that people receiving SSRIs were nearly twice as likely as those receiving placebo to achieve clinical response (defined as a 25% or more reduction in symptoms). Indirect comparisons of effectiveness suggested that although individual SSRI drugs were similar in their effectiveness, they differed in terms of their adverse effects. The most common adverse effect reported by participants was nausea. Further studies involving head to head comparisons between different SSRI drugs are required to obtain more reliable information on differences between SSRIs, both in terms of effectiveness and adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 23, 2008

Although meditation therapy is widely used in many anxiety‐related conditions there is still a lack of studies in anxiety disorder patients. The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessivecompulsive disorders compared with Relaxation/Meditation. Drop out rates appear to be high, and adverse effects of meditation have not been reported. More trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 25, 2006

Autism spectrum disorders (ASD) are characterised by problems with social interaction and communication, as well as repetitive behaviours and limited activities and interests. Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that are sometimes given to reduce anxiety or obsessivecompulsive behaviours. We found nine trials, involving 320 people, which evaluated four SSRIs: fluoxetine, fluvoxamine, fenfluramine and citalopram. Five studies included only children and four studies included only adults. One trial enrolled 149 children, but the other trials were much smaller. We found no trials that evaluated sertraline, paroxetine or escitalopram. There is no evidence to support the use of SSRIs to treat autism in children. There is limited evidence, which is not yet sufficiently robust, to suggest effectiveness of SSRIs in adults with autism. Treatment with an SSRI may cause side effects. Decisions about the use of SSRIs for established clinical indications that may co‐occur with autism, such as obsessivecompulsive disorder and depression in adults or children, and anxiety in adults, should be made on a case‐by‐case basis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: August 20, 2013

Autism spectrum disorders (ASD) are characterised by problems with social interaction and verbal and non‐verbal communication, as well as restricted and repetitive interests and behaviours. Tricyclic antidepressants (TCAs) are medications that alter the level of the neurotransmitter serotonin and have been used in the treatment of autistic symptoms, anxiety and obsessivecompulsive type behaviours. We found three trials that studied two different TCAs ‐ clomipramine and tianeptine. One of the clomipramine studies involved children and young adults; the other two studies enrolled only children. All three trials were small, with between 12 and 32 participants. There is only limited evidence to support the use of clomipramine or tianeptine in the treatment of individuals with ASD, and some evidence of side effects that would limit their usefulness. Clinicians considering the use of TCAs in ASD need to be aware of the limited and conflicting evidence of effect and the side effect profile of TCAs when discussing this treatment option with patients with ASD and their carers. More research is required before TCAs can be recommended for use in ASD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 14, 2012

We all feel scared sometimes. This can help protect us in dangerous situations: It makes us more alert so that we can react quickly. But fear is counterproductive if it makes you constantly worry about a lot of different things. People who do this may have generalized anxiety disorder.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 19, 2017

This summary will tell you about research on how well some antipsychotic medicines work for conditions other than psychosis and bipolar disorder. It will also tell you about research on the risks of side effects for these medicines.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: August 1, 2012

Cognitive behavioral therapy (CBT) is one of the most common and best studied forms of psychotherapy. It is a combination of two therapeutic approaches, known as cognitive therapy and behavioral therapy.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 8, 2016

Anxiety is a very common mental health problem in the general population. Passiflora, a herbal medicine, could be an option for treating anxiety if shown to be effective and safe. This review summarised the evidence from currently available studies on passiflora. Only two studies were eligible for inclusion, involving a total of 198 participants. One study showed that passiflora was as effective as benzodiazepines, with similar dropout rates between the two treatments. Given the lack of studies, it is not possible to draw any conclusions on the effectiveness or safety of passiflora in the treatment of anxiety disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 24, 2007

Anxiety disorders are highly prevalent and result in substantial socio‐economic and personal costs. A significant proportion of patients with anxiety disorders fail to respond to first‐line medication interventions. This was a systematic review of 28 short‐term randomised controlled trials of medication augmentation for the treatment of such individuals (740 participants). A significantly larger proportion of patients responded to medication (31.8%) than to placebo (13.6%), (nine trials, 250 participants). Symptom severity was also significantly reduced (14 trials, 337 participants). A substantial proportion of the efficacy evidence base was for the augmentation with antipsychotics of serotonin reuptake inhibitors for obsessive compulsive disorder.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 18, 2006

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 7, 2015

Anxiety disorders are some of the most prevalent mental disorders. Morita therapy, a systematic psychological therapy based on eastern philosophy, has been used to treat anxiety disorders for decades. It encourages people with anxiety disorders to accept anxiety as a natural feeling, while at the same time it engages them in constructive behaviours via four phases, which sequentially are bed rest in isolation, light work, heavy work and preparation for normal daily living. Acceptance is merely redirecting attention towards purposeful behaviour. People get better when they stop trying to eliminate anxiety and fulfil their desires with study and work in their actual personal and social lives.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 19, 2015

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician‐rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 18, 2006

People who suffer from anxiety and their families.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 12, 2016

People with anxiety disorders and alcohol use problems, as well as their healthcare providers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 20, 2015

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