An OCD treatment we'll keep coming back to?

Obsessive Compulsive Disorder (OCD) is a condition characterised by unreasonable thoughts and fears (obsessions) that lead to repetitive behaviours (compulsions). The archetypal example is hand-washing, but there are many different forms. In the case of hand-washing, to ease the fear of contamination, one may compulsively wash one's hands until they are chapped and sore (i.e. self-harm), yet still be unable to rid oneself of the conviction of ongoing risk from germs.

In fact, every addiction is an expression of OCD - the alcoholic compulsively returns to drink to ease (often unconscious) obsession, and the food addict returns to the fridge to avoid underlying emotional disturbance. Given the incidence of addiction in our culture, the level of need for effective treatment of OCD is clear.

A German research team has recently reported on an internet-based writing approach, with some promising results.

In an article published in Psychotherapy and Psychosomatics, whose title begins 'No talking, just writing', the team describes how 34 volunteers with DSMIV-classified OCD were randomised into a treatment and a control group, with follow-up at eight weeks and six months. The internet-based writing intervention consisted of 14 sessions and the main outcome measure was change in severity of OCD symptoms.

Symptoms were significantly improved in the treatment group and the effect remained consistent at six-month follow-up. Compliance was excellent, with only four participants (12%) leaving the study prematurely. Of the thirty completers, 90% considered their condition improved and would recommend such intervention to their friends.

So is internet-based writing therapy the way ahead for OCD? Obviously, larger sample sizes are needed, but this research clearly suggests positive potential.

What's your treatment experience with OCD, either as a patient or a clinician? How effective is medication and/or talk therapy in your experience and can you imagine a role for the internet in managing the condition? We'd love to hear your thoughts and insights.

Written by Jacqui Hogan