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Brief Treatment and Crisis Intervention 3:145-168 (2003)
© 2003 Oxford University Press

Obsessive-Compulsive Disorder, Comorbid Depression, Substance Abuse, and Suicide Attempts: Clinical Presentations, Assessments, and Treatment

   Albert R. Roberts, PhD
   Kenneth Yeager, PhD, LISW
   Alan Seigel, MSW, BCD

From the Interdisciplinary Program in Criminal Justice and the Administration of Justice Program at Rutgers—The State University of New Jersey (Roberts), the Obsessive Compulsive Disorder Treatment Program at Baystate Medical Center and the Department of Psychiatry at Tufts University School of Medicine (Seigel), and the Department of Psychiatry at the Ohio State University (Yeager).

Contact author: Kenneth Yeager, PhD, LISW, Director of Quality Assurance, Department of Psychiatry, OSU and Harding Behavioral Healthcare and Medicine, Ohio State University Medical Center, 120 Neurosciences Facility, 1670 Upham Drive, Columbus, OH 43210. E-mail: Kyeager{at}adelphia.net or yeager-1{at}medctr.osu.edu.

Persons with obsessive-compulsive disorder (OCD) in singular presentation may experience profound threats to self-esteem; activities of daily living; marital, family, social relationships; and occupational functioning. OCD is present in a number of comorbid conditions, the most risky of which elevate suicide risk. This paper examines the prevalence, assessment methods, clinical features, and treatment approaches to OCD, and depression, substance abuse, or psychotic episodes in comorbid presentation, where threats to the functioning and survival of the individual as well as complications in clinical treatment may arise because of the interplay of symptoms of OCD, substance abuse, brief psychotic episodes, and depression. Case illustrations are used to demonstrate effects of comorbidity and considerations in treatment planning. This article closes by calling for longitudinal research on the causes, consequences, and efficacy of integrated treatment of OCD, depression, substance abuse, and suicidality. [Brief Treatment and Crisis Intervention 3:145–167 (2003)]

KEY WORDS: obsessive-compulsive disorder, major depression, substance abuse, suicide ideation, suicide attempts, assessment, cognitive-behavioral therapy, exposure and response prevention, psychotropic medication






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