Description: I hope you are washing your hands A LOT these days! In fact, might you say that you are washing your hands compulsively? That is not really an appropriate descriptor but here is something to think about. What effect do you think the appropriate jump in hand washing over the past 8 months and its associated concerns and fears about Covid infections has had on Psychologists’ and Psychiatrists’ ability to diagnose Obsessive Compulsive Disorder? Add to that the fact that many client-Psychologist contacts thee days are being conducted using tele-health models and the question get even more complicated. Compulsive handwashing and associated fears of contamination ARE among a number of possible indicators of OCD. So, if you were a Clinical Psychologist, how would you sort out symptoms of OCD from signs a good health practice? Think about that for a moment and then read the article linked below that discusses this questions along with some relevant Psychological research.
Source: Obsessive-Compulsive Disorder: Research Update, Candace Good, Own Your Present, Psychology Today.
Date: October 23, 2020
So, you can see the challenge in treating a disorder like OCD when the treatment could involve leaving the house and not washing one’s hands “excessively”. The research into bio-(brain) markers of treatment efficacy is interesting as it could suggest ways to evaluate treatment progress without the complexities of client self-report (or at least with a way to calibrate the self-reports). I found the discussion of the research project looking at the effects of cannabis on symptom severity in OCD patients interesting as well. Cannabis has been seen to be quite effective in helping individuals with PTSD manage their symptoms and the research reported in the linked article shows another potential area of application, though there were concerns about the design of that study and the longevity of effects. As is usually the case, more research is needed.
Questions for Discussion:
- How might the current Covid pandemic make diagnosis of OCD more challenging?
- How might the current Covid pandemic make the treatment of OCD more challenging?
- What do you think the next steps should be in relation to the possible efficacy of cannabis in the management of symptoms of OCD: give up or do more research and if the latter what sorts of designs should be used?
References (Read Further):
Sheu, J. C., McKay, D., & Storch, E. A. (2020). COVID-19 and OCD: Potential impact of exposure and response prevention therapy. Journal of Anxiety Disorders, 102314. Link
Norman, L. J., Mannella, K. A., Yang, H., Angstadt, M., Abelson, J. L., Himle, J. A., … & Taylor, S. F. (2020). Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial. American Journal of Psychiatry, appi-ajp.
Mauzay, D., LaFrance, E. M., & Cuttler, C. (2020). Acute Effects of Cannabis on Symptoms of Obsessive-Compulsive Disorder. Journal of Affective Disorders.
Rangaprakash, D., Tadayonnejad, R., Deshpande, G., O’Neill, J., & Feusner, J. D. (2020). FMRI hemodynamic response function (HRF) as a novel marker of brain function: applications for understanding obsessive-compulsive disorder pathology and treatment response. Brain Imaging and Behavior, 1-19. Link
Szejko, N., Fremer, C., & Müller-Vahl, K. R. (2020). Cannabis Improves Obsessive-Compulsive Disorder—Case Report and Review of the Literature. Frontiers in Psychiatry, 11, 681. Link
LaFrance, E. M., Glodosky, N. C., Bonn-Miller, M., & Cuttler, C. (2020). Short and long-term effects of cannabis on symptoms of post-traumatic stress disorder. Journal of affective disorders. Link
Lake, S., Kerr, T., Buxton, J., Walsh, Z., Marshall, B. D., Wood, E., & Milloy, M. J. (2020). Does cannabis use modify the effect of post-traumatic stress disorder on severe depression and suicidal ideation? Evidence from a population-based cross-sectional study of Canadians. Journal of psychopharmacology, 34(2), 181-188. Link