Biological Therapies
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Discuss biological therapies for OCD (8 + 16 marks)
The neuroanatomical explanation of OCD suggests that the orbital-frontal cortex, caudate nuclei and the thalamus make up a circuit with a function of converting sensory information into thoughts and actions. Many scientists believe that OCD is thought to involve a serotonin deficiency which causes the caudate nucleus to function poorly within the worry circuit; this means that the caudate nucleus does not filter worry signals from the Orbital Frontal Cortex.
Drug therapy is currently the most commonly used treatment for OCD. Two types of drugs are used these are anti-anxiety and anti-depressant drugs. An example of an anti-depressant drug is Selective Serotonin Re-uptake Inhibitors (SSRIs), which treats the serotonin deficiency by blocking the reuptake of serotonin so that the caudate nucleus can do its job properly and filter out the less powerful signals for distress. SSRIs are generally a very specific drug that treats the targeted area. An example of an anti-anxiety drug is Benzodiazepines (BZs), these calm the brain in a very general way by making neurons less likely to pass on signals. BZs make brain neurons less excitable, which means that a person is less inclined to be anxious and obsessive.
A major strength of drug therapy is that it does not require a lot of active participation from the patient and it is easy and convenient to just simply take drugs. This means that drug therapy is especially good for people who have limited intelligence, lack insight or are unwilling to talk about their thoughts or feelings. An example of this would be if someone has been bullied in the past and then developed a hoarding compulsion they may not be willing to talk about the past experiences but could be helped if they only had to take a simple drug. SSRIs are easily tolerated and are safe, even for older patients. This shows that drug therapy is appropriate for people who would not be helped through other much harder therapies.
Another strength of drug therapies is that SSRIs have been found effective in the treatment of OCD. A study which supports this proposition is put forward by Soomro et al. (2008), who conducted a meta-analysis on the use of SSRIs with OCD and found them to be more effective than placebos in reducing symptoms of OCD up to three months after treatment. Suggesting that drugs actually do work and it is not just the idea that you are taking a drug that reduces the symptoms, which suggests drug therapy is effective.
However, it is worth considering from another perspective that, drug therapy is not an effective treatment of OCD as drugs only treat the symptoms not the cause which results in the patient possibly relapsing when the medication is stopped. Studies on SSRIs only report a 50% improvement in symptoms suggesting that there are other explanations of OCD which therefore means the drugs do not treat the cause. This proposes that drug therapy should be thought of as more of a short term treatment rather than a long term treatment. Therefore suggesting that drugs cannot provide a complete treatment as they simply focus on symptoms alone.
A criticism that supports drug treatment is that research has shown that it is effective and appropriate in severe cases of OCD. This is due to the fact that BZs are fast acting and they are therefore useful in cases where there is a severe risk of self-harm. This also means that drug therapies can help these severe cases where the patient is unlikely to engage in talking therapies. By reducing the symptoms of OCD it is more likely that the severe cases become able to speak about their obsessions and compulsions. This would suggest that sometimes it is extremely effective for drug treatments to be backed up by therapies such as ERP and REBT. This supports the view that drugs are both effective and appropriate for treating OCD, as a major criticism is that it is a short term treatment but it can help the patient become able to take part in long term and cause treating therapies.
Psychosurgery is a surgical intervention that aims to treat a behaviour for which no rational cause can be established. A certain criteria must be met