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Last Updated: Wednesday, 23 November 2005, 01:39 GMT
GPs get obsessive disorder advice
Image of washing hands
Compulsive handwashing is a common symptom of OCD
Doctors in England and Wales are being given guidelines on how to diagnose patients with Obsessive Compulsive Disorder more easily.

As many as two in every 100 people have the disorder, with its ritualistic behaviour and irrational thoughts, yet many are too embarrassed to seek help.

Many wait up to 17 years to be diagnosed and get efficient treatment.

The National Institute for Health and Clinical Excellence guidance outlines the symptoms to look for in sufferers.

People with these conditions hide them and don't want to talk about it...and professionals do not ask the right questions
Dr Tim Kendall, who developed the guidelines

It also covers a similar, but unrelated anxiety disorder called body dysmorphic disorder where the individual is excessively preoccupied with a minor or imaginary physical defect in their appearance, such as a less than perfect nose.

These people often seek help from cosmetic surgeons, but the real aid they need is psychological support, says NICE.

Similarly, people with OCD, particularly those under 18, should be offered talking therapies - namely cognitive behavioural therapy (CBT) - in the first instance.

This can include a therapy called exposure response prevention (ERP) which helps people deal with situations or things that make them anxious or frightened by exposing them to the problem and teaching them new ways to cope with it.

Getting help

If an adult's OCD is more severe, medication with a class of antidepressants called SSRIs might also be helpful and should be offered instead of or in combination with CBT, says NICE.

Ultimately, it will be up to the patient to decide the treatment they want, along with the help and support of healthcare professionals and loved ones, says the guidance.

Dr Tim Kendall, joint director of the National Collaborating Centre for Mental Health who developed the guidelines on behalf of NICE, said the new guidance should help more people get diagnosed and treated.

"The average time to treatment is 17 years from first onset of the illness. OCD and BDD involve a huge amount of shame and embarrassment.

"People with these conditions hide them and don't want to talk about it...and often professionals just do not ask the right questions.

"We are not doing a fantastic job for these people there is no doubt."

Do you wash or clean a lot?
Do you check things a lot?
Is there any thought that keeps bothering you that you'd like to get rid of but can't?
Do your daily activities take a long time to finish?
Are you concerned about putting things in special order or are you very upset by mess?
Do these problems trouble you?

But he said many more professionals needed to be trained to deliver the psychological therapies that could help.

He said the Department of Health were discussing plans to increase the number of trained psychological therapists by about 6,000.

Professor Mark Freeston, professor of clinical psychology at Newcastle University and chairman of the guideline development group said it was more a question of reorganising existing resources.

He said that healthcare professionals were very receptive to being trained and added "the expertise to train is also there".

Dr Isobel Heyman, consultant child and adolescent psychiatrist at the Maudsley and Great Ormond Street Hospitals, London, said: "OCD really can destroy young lives.

"They can spend six or seven hours a day washing and they may not be able to go to school because of their rituals.

"This guideline should help raise awareness amongst the parents and carers of young people of the signs to look out for to ensure young people with OCD receive access to the treatments they need.

"It's such a treatable problem."

Charities OCD Action and OCD-UK both welcomed the guidelines.

How OCD blights the lives of sufferers

Why some people become hoarders
20 Dec 04 |  Health
Hoarding not a usual compulsion
03 Jun 04 |  Health


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