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Handbook on Obsessive-Compulsive and Related Disorders


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Table of Contents

ContributorsForewordChapter 1. Introduction and Major Changes for the Obsessive-Compulsive and Related Disorders in DSM-5Chapter 2. Obsessive-Compulsive DisorderChapter 3. Body Dysmorphic DisorderChapter 4. Hoarding DisorderChapter 5. Trichotillomania (Hair-Pulling Disorder)Chapter 6. Excoriation (Skin-Picking) DisorderChapter 7. Other Obsessive-Compulsive and Related Disorders in DSM-5Chapter 8. Tic DisordersChapter 9. Illness Anxiety DisorderChapter 10. Obsessive-Compulsive Personality DisorderChapter 11. ConclusionsIndex

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This book is a marvelous achievement, invaluable for both clinicians and researchers! The editors, Drs. Katharine Phillips and Dan Stein, have gathered foremost experts to summarize current knowledge regarding all the DSM-5 Obsessive-Compulsive and Related Disorders, and the disorders that were strong candidates for inclusion, e.g., tic disorders, illness anxiety disorder (formerly hypochondriasis) and obsessive-compulsive personality disorder. This comprehensive text is richly supplied with illustrative cases, useful screening and severity measures, well-designed summary tables, pointers to helpful websites, and thoughtful reviews of differential diagnosis, comorbidity, course, familial, genetic and environmental risk factors, neural substrates, biomarkers, and of treatments, psychotherapeutic and psychopharmacological as well as psychosocial and newer biological interventions. Clinicians who consult this sound guide will find their ability to alleviate the human suffering caused by these often missed, painful and life-impairing disorders magnified greatly. Researchers will be guided toward the gaps in our knowledge, which, if bridged, offer great gains in treatment effectiveness. Lorrin Koran, M.D.

About the Author

Katharine A. Phillips, M.D., is Professor of Psychiatry and Human Behavior at Alpert Medical School of Brown University; and Senior Research Scientist and Director of the Body Dysmorphic Disorder Program at Rhode Island Hospital in Providence, Rhode Island. Dan J. Stein, M.D., Ph.D., is Professor and Chair of the Department of Psychiatry at the University of Cape Town in Cape Town, South Africa.


This Handbook has a story that has its roots in the text by Eric Hollander, Joseph Zohar, Paul J. Sirovatka & Darrel A. Regier, Obsessive-Compulsive Spectrum Disorders. Refining the Research Agenda for DSM-V (Washington, DC: American Psychiatric Publishing, 2011), and in the innovations that were introduced with the DSM-5: in particular, the inclusion of obsessive compulsive disorder in a separate sector compared to that in which it was previously placed, ie the area of anxiety disorders. This change, in the opinion of the authors, has a significant impact on improving the way in which clinicians diagnose and treat patients who present the broad spectrum of situations that revolve around obsessive and compulsive issues. But also, researchers can find in this new arrangement - which, it should be remembered, includes different configurations in addition to the classic obsessive-compulsive disorder - a different and more useful basic framework (see pp. 271-306 of the DSM-5. and statistics of mental disorders Milan: Raffaello Cortina, 2014). The eleven chapters of the text, written by twenty-two authors who have all been involved in the work of the Obsessive-Compulsive Spectrum Sub-Work Group for the development of the DSM-5, covers a wide range of clinical situations (from accumulation disorders to tic, trichotillomania and excoriation disorders), especially considering the fundamental aspects of diagnosis, differential diagnosis and treatment. About this second point the indication that runs through the entire text is that of cognitive-behavioral therapy (Cognitive-Bahavioral Therapy [CBT]), considered as the first-line treatment together with the latest generation drugs, selective inhibitors of the re-uptake of serotonin (known as SSRI, from the English Selective Serotonin Reuptake Inhibitors). A modest space is then reserved for what is called "psychoeducation", while psychodynamic therapy is mentioned en passant only once and critically. The interest in the complex of obsessive-compulsive disorders also arises from the spread of these problems and from the frequent situation of comorbidity (especially anxiety, depressive and bipolar disorders). The age of onset is around nineteen years and if it is not treated this disorder tends to fluctuate, exacerbating, with a high possibility of becoming chronic. Several authors of the text emphasize the high cost (social and financial) paid by the company because of the impediments that force patients affected by this condition to fail to cope with normal life commitments: as stated in the DSM-5, we estimates that, at world level, the percentage of the affected population is between 1.1% and 1.8%, with a slight prevalence of females on males, observing that the onset in the male population is often precocious, ie placed in the childhood age. The text also includes three chapters dealing with topics strongly related to obsessive and compulsive disorders, but which have been placed in other areas of the Manual in the DSM-5: tic disorders, the new version of hypochondria (called "Anxiety Disorder" of disease ") and obsessive-compulsive personality disorder. On some topics related to the topic covered in the text it may be useful to consult Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors, signed by Jon E. Grant, Dan J. Stein, Douglas W. Woods & Nancy J. Keuthen (Washington, DC: American Psychiatric Publishing, 2012). * Psicoterapia e Scienze Umane, 2017, Vol. 51, No. 1. *

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