Psychiatric Bulletin (2008) 32: 333-336. doi: 10.1192/pb.bp.107.017517
© 2008 The Royal College of Psychiatrists
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National service for adolescents and adults with severe obsessive-compulsive and body dysmorphic disorders{dagger}

L. M. Drummond, Consultant Psychiatrist and Senior Lecturer

Division of Mental Health, St George’s, University of London, Cranmer Terrace, London SW17 ORE, email: lynnemd{at}sgul.ac.uk, and South West London and St George’s Mental Health NHS Trust

N. A. Fineberg, Consultant Psychiatrist

University of Hertfordshire and Queen Elizabeth II Hospital, Welwyn Garden City

I. Heyman, Consultant Child and Adolescent Psychiatrist

Institute of Psychiatry, King’s College London

P. J. Kolb, Cognitive Behavioural Psychotherapist, A. Pillay, Cognitive Behavioural Psychotherapist and S. Rani, Associate Specialist

Behavioural-Cognitive Psychotherapy Unit, South West London and St George’s Mental Health NHS Trust

P. Salkovskis, Professor of Clinical Psychology and Applied Science and D. Veale, Consultant Psychiatrist in Cognitive-Behavioural Therapy

Institute of Psychiatry, King’s College London

Declaration of interest

All authors work in the services described but have no other interest in this paper.

{dagger} See original paper, pp. 336-340, this issue.

AIMS AND METHOD

National guidelines for the assessment and treatment of obsessive-compulsive disorder (OCD) and body dysmorphic disorder were published in 2005 by the National Institute for Health and Clinical Excellence (NICE). Local services are unable to treat a small but significant number of the most severely ill patients successfully, and the guidelines recommend that such patients should have access to highly specialised care. From 1 April 2007, the Department of Health decided to centrally fund treatment services for severe, chronic, refractory OCD and BDD. We describe a new National Service for Refractory OCD; its rationale, treatments offered, referral criteria and expected clinical outcomes.

RESULTS

Initial results from one centre show an average 42% reduction in OCD symptoms at the end of treatment.

CLINICAL IMPLICATIONS

The operational challenges and potential generalisability of this model of healthcare delivery are discussed. We present a summary of the progress made so far in establishing a new, coherent National Service for Refractory OCD, 18 months after the NICE guideline was published. The aim of the paper is to educate clinicians about the service and describe its rationale, treatments offered, referral criteria and expected clinical outcomes.


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Community model in treating obsessive-compulsive and body dysmorphic disorders
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PB 2008 32: 336-340. [Abstract] [Full Text]