Clinical Specialties : Psychiatric Illness

Obsessive Compulsive Disorder

Obsessive Compulsive disorder affects approximately 2% of the population in the United States. It is the fourth most common neuropsychiatric illness. It is the tenth leading cause of disability worldwide. It affects 1 in 40 adults and 1 in 200 children.

Treatment

Medications

Often, obsessive compulsive disorder, can be treated with a combination of medication and cognitive behavioral therapy (CBT). The most common medications are part of a group of drugs known as Serotonin reuptake inhibitors (SSRI). It is postulated that a neurotransmitter called serotonin is out of balance in those patients affected. Unfortunately, approximately, 10-20% of patients treated optimally with SSRIs and CBT do not get better.

Deep Brain Stimulation

More recently, through the use of advances in imaging of the brain the neurocircuitry responsible for OCD is better understood. As a result of this, further treatment options are available.

Recently, the FDA approved a procedure called Deep Brain Stimulation for use in OCD. This procedure implements chronic electrical stimulation to deep areas of the brain allowing for significant improvement in symptoms. It is similar to a pacemaker for the heart. Although large prospective randomized trials have not been performed yet, smaller studies have shown significant efficacy. Patients may expect up to 60% improvement in symptoms after surgery.

Not all patients are candidates for this procedure and at the University of Miami a multidisciplinary team consisting of Psychiatrists, Neurologists, Neuropsychologists, and Neurosurgeons evaluate prospective patients. Additionally, advanced imaging and state of the art targeting computers are used to produce the best result.