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Behaviour therapy for obsessive compulsive disorder in a 78-year-old woman
1Institute of Psychiatry, London, UK.
Objective:
To describe a case of late onset obsessive compulsive disorder (OCD) and determine the impact of a behavioural intervention on OCD symptoms.
Design:
A single case design was undertaken in which the severity of the patient's OCD symptoms was measured before and after treatment.
Setting:
The intervention was undertaken in the patient's home.
Patient:
A 78-year-old woman with a history of depression who experienced sudden onset and rapid escalation of OCD following a domestic accident.
Intervention:
A behavioural procedure involving continuous in vivo exposure and response prevention over an 8-hour period.
Measures:
The Y-BOCS self-rating scale (Yale Brown Obsessive Compulsive Scale) and clinical observation.
Results:
Y-BOCS score improved from 35 prior to treatment to 12 post treatment (mean for OCD population = 25.1; SD = 6, Goodman et al., 1989). Improvement was maintained at 2 months follow-up (Y-BOCS = 11). Improvements in confusion and agitation were also observed.
Conclusions:
This case study supports the use of behavioural interventions for elderly patients suffering from OCD. Risk factors and treatment designs are discussed in view of the literature.
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