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Inpatient Treatment of Patients With Severe Obsessive-Compulsive Disorder
Lisa Calvocoressi; Christopher I. McDougle; Suzanne Wasylink; Wayne K. Goodman; Sally J. Trufan; Lawrence H. Price
Psychiatric Services 1993; doi:
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This work was supported in part by grants MH25642, MH30929, MH36229, and MH45803 from the National Institute of Mental Health and by the state of Connecticut. The authors also acknowledge the outstanding work of the clinical and administrative staffs of the clinical neuroscience research unit at Yale University.

Connecticut Mental Health Center; Yale University School of Medicine, 34 Park Street, New Haven, Connecticut 06519.

1993 by the American Psychiatric Association

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Abstract

Patients with obsessive-compulsive disorder may experience severely disabling symptoms and require hospitalization. Based on treatment of 77 such patients admitted to a long-term general psychiatric research unit over a seven-year period, the authors present pharmacologic, psychosocial, and behavioral managment strategies for treating these patients on general psychiatric units. The treatment guidelines require only modest modifications of standard practice and can be adapted for use on general units without specialized staff training. Some patients with obsessive-compulsive disorder exhibit strong control and dependency needs and disrupt the milieu in characteristic ways. These patients may generate conflict among staff about whether the patients can control obsessive-compulsive behaviors; they may anger other patients because of the large amount of staff attention they demand. Educating staff about obsessive-compulsive patients' control and dependency needs and enlisting the support of fellow patients can improve the milieu.

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