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A mixed approach: Posttraumatic obsessive compulsive disorder

Published online by Cambridge University Press:  23 March 2020

R. Landera Rodríguez
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
M. Gómez Revuelta
Affiliation:
Hospital Universitario de Álava-Sede Santiago, Psychiatry, Vitoria-Gasteiz, Spain
M. Juncal Ruíz
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
O. Porta Olivares
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
R. Martín Gutiérrez
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
L. Sánchez Blanco
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
D. Abejas Díez
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
G. Pardo de Santayana Jenaro
Affiliation:
Hospital Universitario Marqués de Valdecilla, Psychiatry, Santander, Spain
M. Fernández Rodríguez
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Medicine, Santander, Spain
L.A. Giraldo Vegas
Affiliation:
Hospital Universitario Marqués de Valdecilla, General Medicine, Santander, Spain

Abstract

Introduction

Several studies along the last two decades provide information indicating the relationship between posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). The particular features described in patients who developed OCD symptoms closely after the onset of PTSD, may suggest the existence of a specific subtype of OCD more likely to be suffered after a traumatic event. The few studies focused on evaluating treatment efficacy for the association between OCD and PTSD seem to predict poor response to pharmacologic or behavioral cognitive (BCT) monotherapy.

Objectives

Despite the evidence, most widely used guidelines propose the employment of either a psychotherapeutic or psychopharmacologic approach. We propose to combine intensive BCT and serotonin profile antidepressants in order to optimize PTSD-OCD subtype.

Material and methods

We present two detailed case reports offering the results of combining intensive BCT and serotonin profile antidepressants as soon as the comorbid diagnosis for both disorders was established. These two patients were recruited from outpatient care centers.

Results

Our limited experience supplied promising outcome results. Significant improvement regarding to functional impairment appeared from early stages of the treatment in both patients.

Discussion

Despite logistic difficulties, an intensive and coordinated psychopharmacologic and psychotherapeutic approach might constitute another treatment choice which may be taken into account in those cases monotherapy fails to reduce PTSD-OCD subtype patients’ impairment.

Conclusions

A mixed treatment approach might be taken into account as a first line treatment in PTSD-OCD disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: anxiety disorders and somatoform disorders
Copyright
Copyright © European Psychiatric Association 2017
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