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Diagnostic Dilemmas in symposium on OCD: ENIGMA WRAPPED IN A RIDDLE

Conference Paper


Abstract


  • Described as the ‘hidden epidemic’, Obsessive Compulsive Disorder (OCD) is one of the most ubiquitous, yet underdiagnosed and undertreated, mental health disorder. Lifetime prevalence is estimated at around 2-3% but, together with comorbidities and regional variations OCD probably contributes a relatively higher proportion of the global burden of disease The diagnostic spectrum has been amplified in the DSM-5 to include body dysmorphic disorder, hoarding disorder, trichotillomania and excoriation, now classified as 'OCD and related disorders' (OCRDs). The ICD-11 adds hypochondriasis, olfactory reference syndrome and Tourette syndrome to the basket. This adds to greater heterogeneity and renders the epidemiologic, phenomenological, aetiological, neurobiological and therapeutic conundrum even more complex. While recent genetic and molecular research has helped unravel some of the neurobiological mechanisms underlying this group of disorders, many areas of darkness remain. Gene environment interactions encompassing an array of adverse perinatal and other traumatic events contribute to its genesis. While several brain regions and neuronal circuits have been implicated, most are yet to be credibly validated. Therapeutic interventions including CBT, psychopharmacological agents, deep brain stimulation have been trialed, reflected in the many complex treatment algorithms. Yoga and acupuncture have been found to be helpful in a subset of patients, but for many the quality of life remains compromised even after a long and often arduous therapeutic journey. At the end of the day, this veritable 'enigma wrapped in a riddle' continues to pose a Byzantine challenge to researchers and clinicians alike. .

Publication Date


  • 2021

Citation


  • Pai, N. (2021, October 18). Diagnostic Dilemmas in symposium on OCD: ENIGMA WRAPPED IN A RIDDLE. In World congress of Psychiatry 2021. virtual congress ( Columbia).

Web Of Science Accession Number


Abstract


  • Described as the ‘hidden epidemic’, Obsessive Compulsive Disorder (OCD) is one of the most ubiquitous, yet underdiagnosed and undertreated, mental health disorder. Lifetime prevalence is estimated at around 2-3% but, together with comorbidities and regional variations OCD probably contributes a relatively higher proportion of the global burden of disease The diagnostic spectrum has been amplified in the DSM-5 to include body dysmorphic disorder, hoarding disorder, trichotillomania and excoriation, now classified as 'OCD and related disorders' (OCRDs). The ICD-11 adds hypochondriasis, olfactory reference syndrome and Tourette syndrome to the basket. This adds to greater heterogeneity and renders the epidemiologic, phenomenological, aetiological, neurobiological and therapeutic conundrum even more complex. While recent genetic and molecular research has helped unravel some of the neurobiological mechanisms underlying this group of disorders, many areas of darkness remain. Gene environment interactions encompassing an array of adverse perinatal and other traumatic events contribute to its genesis. While several brain regions and neuronal circuits have been implicated, most are yet to be credibly validated. Therapeutic interventions including CBT, psychopharmacological agents, deep brain stimulation have been trialed, reflected in the many complex treatment algorithms. Yoga and acupuncture have been found to be helpful in a subset of patients, but for many the quality of life remains compromised even after a long and often arduous therapeutic journey. At the end of the day, this veritable 'enigma wrapped in a riddle' continues to pose a Byzantine challenge to researchers and clinicians alike. .

Publication Date


  • 2021

Citation


  • Pai, N. (2021, October 18). Diagnostic Dilemmas in symposium on OCD: ENIGMA WRAPPED IN A RIDDLE. In World congress of Psychiatry 2021. virtual congress ( Columbia).

Web Of Science Accession Number