Obsessive Compulsive Disorder (OCD)

Condition

OCD is a mental health condition in which the patient has obsessive thoughts and engages in compulsive and repetitive activity in a dangerous cycle:

  1. Obsession: obsessive thoughts could be defined as thoughts, urges or images which are unpleasant or unwanted
  2. Anxiety: the obsessive thoughts cause the person to feel anxious, tense, unsettled or disgusted
  3. Compulsion: these are repetitive behaviours which the patient feels they need to carry out to get rid of the obsessive thoughts
  4. Relief: carrying out the compulsive act tends to relieve the urges, but it is short term relief before the obsessive thoughts, anxiety and compulsions start again

In severe cases, patients can become house-bound by the need to repeatedly carry out their compulsions, such as washing, cleaning, counting or other behaviours which can take over their lives.

Signs and Symptoms of OCD

  • Fear of harming yourself or attacking others (worry about loss of self-control)
  • Fear of causing an accident (e.g. leaving the door unlocked and being burgled)
  • Fear or contamination, disease, infection or dirt
  • Need for order or symmetry (e.g. alphabetically stored CDs)
  • Obsessive cleaning and handwashing
  • Repeated checking for safety (e.g. doors locked, gas off)
  • Ordering, arranging, hoarding
  • Neutralising thoughts (e.g. counting, repeating words silently)

Causes/Triggers

There is no one specific or exact cause of OCD, although there are certain factors which can make a person more at risk of developing the condition. These include:

  • Psychological factors – a tendency towards being neat or a perfectionist; or being naturally more anxious can be factors in OCD
  • Stress factors – difficult life events can trigger OCD in those with a tendency towards it (e.g. childbirth, redundancy, bereavement, moving house)
  • Genetic factors – a family history of the condition (inherited factor)
  • Biological factors – a chemical imbalance of serotonin in the brain

This is not a finite list and the above does not necessary mean that you will develop OCD, but there are known links. The circumstances for each patient are often complex.

Conventional Treatments

Treatment should start as early as possible to avoid the OCD cycle becoming deeply entrenched.

There are two main treatments for OCD at the moment:

  • Medication – depression tablets (SSRIs) designed to redress the chemical balances in the brain
  • CBT (Cognitive Behavioural Therapy) – involving ERP (Exposure with Response Prevention)

rTMS at The Smart Clinics in London

Transcranial Magnetic Stimulation therapy treatment is available at Smart TMS, based at The Smart Clinics, Brompton Cross, London. Smart TMS was the first UK clinic to offer treatments for anything other than depression.

On the basis of research, we believe that rTMS – Repetitive Transcranial Magnetic Stimulation could offer sufferers of Obsessive Compulsive Disorder (OCD) an alternative treatment option using transcranial magnetic stimulation to work directly on the associated areas of the brain. It would also offer the benefit of being a non-medication approach, avoiding potentially unpleasant side-effects associated with drugs.

To discuss this further, please contact us.

Review: TMS for OCD

Mr J’s story – treatment at Smart TMS, London

“I was first diagnosed with Obsessive Compulsive Disorder 27 years ago. In that time I had undergone various forms of therapy and treatment in addition to receiving medication. Although this had alleviated the symptoms to some extent, the OCD was still having a major effect on my life.

“The TMS treatment has eliminated almost all of the distressing and unwanted thoughts, and therefore the time spent ruminating and the need to constantly discuss them and worry about them. This has enabled me to function properly and lead a much happier life. My level of fatigue has greatly reduced.

“The TMS treatment was not only effective, but the team involved were very helpful and professional, from the first thoroughly conducted consultation through to the actual treatment itself. There was also a great follow up and aftercare service.

“I will be informing my GP of how well this truly 21st Century approach has worked.”

Mr JTreatment at Smart TMS London

OCD and rTMS Treatment

Research and Studies

Research Studies

Obsessive Compulsive Disorder

There is some evidence that a proportion of patients with OCD, resistant to treatment with psychotherapy and antidepressant medication, will respond to treatment with rTMS.

  • (1) A systematic meta-analysis of the efficacy of rTMS for OCD was conducted.   Data was obtained from 10 randomised controlled studies with a total of 282 subjects with OCD.  Using a standard measure of OCD the pre and post treatment scores showed a significant difference in outcome favoring treatment with rTMS compared to the control groups.  Response rates were 35% for those patients with OCD treated with rTMS.  In conclusion this analyses show that active rTMS seems to be effective for treating OCD (Berlim et al, 2013).
  • (2) A randomized controlled study was conducted on 21 patients suffering from treatment-resistant OCD.   The symptom severity reduced in the group treated with rTMS when compared to the control group.   This study suggested that rTMS is a successful intervention for patients suffering from treatment-resistant OCD (Haghighi et al, 2015)
  • (3) One RCT in France which was 4 weeks of low frequency treatment 20 minutes daily over the bilateral supplementary motor area. This showed no improvement between controls and the active group.  (Pelissolo et al, 2016)
  • (4)  One RCT in Turkey and Bulgaria which was 6 weeks of low frequency treatment for 20 min daily over the bilateral supplementary motor area.  The active treatment group showed a 40% reduction in the severity of symptoms with no change in the control group after 6 weeks.  The main positive changes occurred between week 4 and week 6. (Hawken et al, 2016)