Brief flooding with exposure and response prevention In vivo in OCD

Abstract

Obsessive–compulsive disorder (OCD) is a commonly encountered psychiatric illness. Cognitive behavior therapy (CBT)/exposure and response prevention (ERP) is first-line treatment option for OCD. When facilities are available, CBT/ERP monotherapy may be recommended in mild to moderately ill patients. However, in severely ill patients, the management comprising CBT and pharmacotherapy is more efficacious than single treatment alone. Behaviorists practicing ERP recommend that exposure in real-life situations (vivo) is more effective than in imaginative situations (vitro). Here, we present a case of a middle-aged female with obsessions regarding contamination by menstrual blood and compulsions of checking and cleaning, causing marked sociooccupational deficit. The index patient who was suffering from debilitating form of OCD failed to respond to pharmacotherapy alone and later with combination of pharmacotherapy; brief in vivo flooding and ERP in vitro responded well; which is sustained at 6 months' follow-up.

Keywords

• brief flooding
• erp
• in-vivo
• menstrual blood
• ocd