Severe and Treatment-Resistant OCD: An Evidence-Based Guide for Indian Families
Severe and treatment-resistant OCD is Obsessive-Compulsive Disorder that has not responded fully to first-line treatment but it has a well-evidenced sequence of next-line options.
Senior Consultant Psychiatrist, Abhasa Rehab and Wellness
- Last Updated: 2026-06-19
- Published: 2026-06-19
- 10 min read
Key Takeaways
- About 30–40% of people with OCD do not fully respond to a first SSRI plus ERP according to Pittenger et al. (2021) in the American Journal of Psychiatry [5]. The next steps are well defined and have evidence behind them.
- Optimisation, switching, and augmentation come before procedural treatments. Most "treatment failures" are under-dosed or under-trialled fix that first.
- Atypical antipsychotic augmentation (low-dose risperidone, aripiprazole) has a small-to-moderate average effect on OCD beyond SSRI alone [6][7]
- Intensive ERP (daily, residential or day-care) often helps where weekly outpatient ERP did not.
- TMS is now FDA-cleared for OCD; DBS is reserved for very severe, multi-trial-resistant cases evaluated by specialised teams [10]
- "What this is, when it's considered, who decides" that is the framing throughout this guide. Procedural decisions belong with a psychiatric team that knows you.
Severe OCD (treatment-resistant OCD): Obsessive-Compulsive Disorder (ICD-10 F42; DSM-5-TR 300.3) that has not responded fully to at least one adequate trial of a serotonin reuptake inhibitor (SSRI) at OCD-effective dose for 10–12 weeks AND a course of Exposure and Response Prevention (ERP) delivered by a trained therapist.
Roughly 30–40% of people with OCD meet this definition after first-line treatment alone. Treatment-resistant OCD has a defined next-line sequence: optimisation, switching, augmentation, intensive ERP, and (in severe persistent cases) procedural treatments such as TMS or DBS.
If you are reading this guide, the standard recommendations have probably already been tried. Maybe a course of Exposure and Response Prevention (ERP). Maybe one or two SSRI trials. Maybe both, for many months. And the OCD is still loud still taking hours of the day, still keeping someone you love from work, school, faith, or food.
This is where families often feel most alone. The internet’s confident headlines about ERP and SSRIs do not always match what is happening in their living room. The clinic you went to may not have raised the next steps. And the words you start to encounter treatment-resistant, refractory, augmentation, TMS, DBS sound either too clinical to grasp or too final to bear.
Here is what matters: severe and treatment-resistant OCD has more options than most people realise. About a third of people with OCD do not respond fully to first-line treatment alone. But the great majority of that group respond to one of the next-line options when the team has time to work through them carefully [5].
The aim of this page is to walk through what those options are, when each is considered, who decides, and what an Indian family can realistically expect.
This page is the in-between. We will tell you what ERP actually does, what a session looks like, why it works in the brain, how it is adapted for different OCD subtypes, and why some people find it difficult before they find it freeing. By the end you should know enough to walk into a first appointment with the right questions.
What does "severe" or "treatment-resistant" OCD mean?
Clinically, severe OCD usually refers to a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score in the 24–31 range, with major impairment in work, study, family, and self-care.
Treatment-resistant means the OCD has not adequately responded to at least one or two adequate trials of first-line treatment usually defined as a 10–12 week SSRI trial at the OCD target dose plus an adequate course of ERP [3][5].
These are working clinical definitions, not verdicts. Almost everyone in this group has a path forward, and many of those paths are well evidenced.
About 30–40% of people with OCD do not respond fully to a first SSRI plus ERP and the majority of that group respond to one of the next-line options when their team works through them carefully. Pittenger et al. (2021), American Journal of Psychiatry [5].
Who This Guide Is For
This guide is written for:
- Adults with severe OCD considering what comes after first-line treatment.
- Family members trying to understand a loved one’s options when standard care has not been enough.
- General practitioners and counsellors in India who refer patients onward and want a clear summary of next-line evidence.
- Referring psychiatrists seeking a patient-friendly explanation to share with families.
If you or your loved one feels unsafe right now, please scroll up and call iCall (9152987821) or Tele-MANAS (1-800-91-4416). You will not be judged for asking for help. Reach out to Abhasa Rehab and Wellness today at +91 73736 44444.
What Counts as "Severe" or "Treatment-Resistant" OCD?
QUICK ANSWER
Clinically, severe OCD usually means a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 24 or higher with major impairment in daily functioning. Treatment-resistant OCD usually means the symptoms have not responded adequately to one to two adequate trials of first-line treatment, typically defined as 10–12 weeks of an SSRI at the OCD target dose plus an adequate course of Exposure and Response Prevention (ERP)[3][5].
The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the standard clinical severity measure for OCD [8]. A trained clinician scores ten items covering both obsessions and compulsions on a 0–4 scale, producing a total between 0 and 40:
- 0–7 subclinical
- 8–15 mild
- 16–23 moderate
- 24–31 severe
- 32–40 extreme
Severity is not just the score, though. Two people with the same Y-BOCS can have very different lives if one is housebound and the other is working full-time with structured rituals. Real-world impairment work, study, sleep, family relationships, self-care sits alongside the score.
Treatment-resistant is a slightly different concept. It refers to non-response to adequate treatment, not to severity itself. A person can have moderate OCD that has not responded to two careful SSRI trials and is treatment-resistant. A person can have severe OCD on first presentation, before treatment has been tried, that is severe, not resistant.
The two often overlap, and the same next-line decisions apply.
Step One: Optimise What Has Already Been Tried
QUICK ANSWER
Before moving to next-line treatment, the most important step is making sure the existing treatment was delivered adequately. Many “failed” SSRI trials were underdosed or stopped before 10–12 weeks. Many “failed” ERP courses had insufficient exposure intensity or unrecognised mental compulsions interfering. Optimisation alone resolves a meaningful share of apparent treatment failures [5].
This step is the most often skipped, and the one that most often makes the rest of the sequence unnecessary. Before deciding that a treatment has failed, an experienced psychiatrist will check three things.
An adequate SSRI trial for OCD is usually 10–12 weeks at the target dose, not the starting dose [3]. If the dose was kept low because of mild side effects, or if the trial was stopped at week 4 or 6 because nothing seemed to be happening, that is not a true treatment failure. Many people who “failed” an SSRI in this sense respond well when the dose is titrated up to the OCD range and held there for the full duration.
ERP works through inhibitory learning the brain laying down new “this is safe” memories that compete with the OCD memory. That requires exposures of meaningful intensity, sustained until the natural drop in distress, and daily homework between sessions. Gentle ERP that never quite touches the harder items on the hierarchy often produces little change.
Untreated co-occurring depression makes ERP very hard to engage with. Active substance use can mask response or cause apparent relapse. Sleep deprivation, severe family conflict at home, and stimulant use can all interfere. Sometimes the right next step is not changing OCD treatment at all it is addressing the variable that is blocking it.
If optimisation has already happened adequate dose, adequate duration, real ERP intensity, no interfering condition then the case for next-line treatment is genuine.
Step Two: Switching Within First-Line
QUICK ANSWER
Non-response to one SSRI does not predict non-response to another. The next pragmatic step in treatment-resistant OCD is usually to switch to a different SSRI, or to switch to clomipramine. Each has a different binding profile, and a meaningful number of people who did not respond to a first SSRI do respond to a second [5].
The five SSRIs commonly used in OCD, fluoxetine, sertraline, fluvoxamine, paroxetine, escitalopram share a common mechanism but differ in side-effect profiles, drug interactions, and tolerability. A switch within the SSRI family is reasonable when the first agent did not produce an adequate response despite an adequate trial.
Clomipramine, an older tricyclic antidepressant, has slightly higher response rates than SSRIs (50–70%) but more side effects [6]. It is often the choice when one or two SSRI trials have not been enough, particularly when severity is high. Cardiac monitoring is standard at higher doses.
Step Three: Augmentation
QUICK ANSWER
Augmentation means adding a second medication to boost the response of the first. The strongest evidence supports adding a low-dose atypical antipsychotic (commonly risperidone or aripiprazole) to an SSRI in treatment-resistant OCD.
Pooled trials show a small-to-moderate average effect [6][9]. Glutamate modulators such as memantine and N-acetyl cysteine (NAC) have emerging but less mature evidence [6].
When optimisation and switching have not been enough, augmentation is the next pharmacological step. Two main families are used.
Adding a low-dose atypical antipsychotic to an SSRI is the most-studied augmentation strategy in OCD. The Bloch 2006 systematic review of trials of antipsychotic augmentation in treatment-refractory OCD found a meaningful effect, though responder rates vary by agent and study [9].
Risperidone and aripiprazole are the most commonly used. The doses for OCD augmentation are typically lower than the doses for psychotic disorders. Side-effect monitoring covers metabolic effects (weight, glucose, lipids), prolactin, extrapyramidal symptoms, and sedation.
The decision to start an antipsychotic, even at a low dose, belongs with a psychiatrist familiar with both medications.
Newer OCD research has increasingly pointed to glutamate dysregulation as a second important neurotransmitter system in OCD beyond serotonin.
Memantine (originally an Alzheimer medication), N-acetyl cysteine (NAC, available as a supplement), and other glutamate-active agents have been tried as augmentation, with emerging though less mature evidence [6]. They are sometimes considered when antipsychotic augmentation is not tolerated or has not worked.
Smaller bodies of evidence exist for other agents lamotrigine, riluzole, ondansetron and these are sometimes used in highly refractory cases at specialist centres. The evidence base is smaller than for antipsychotics or glutamate modulators.
The choice of augmentation agent depends on the person’s other medical conditions, prior medication history, and side-effect tolerability. It is a clinical conversation, not an algorithm.
From our psychiatry team at Abhasa: “Augmentation is not ‘failure of the SSRI’. It is the next planned step in a sequence. Most patients who arrive at this point have not had the SSRI properly optimised first getting that right alone resolves a meaningful fraction of treatment resistance.” Dr. Shree Aarthi, MBBS, MD, DNB (Psychiatry), Consultant Psychiatrist, Abhasa Rehab and Wellness
Step Four: Intensive ERP and Combined Programmes
QUICK ANSWER
Intensive ERP daily or twice-daily sessions across two to three weeks, often in a residential or day-care setting, frequently produce meaningful change for people whose weekly outpatient ERP has not been enough. Combining intensive ERP with augmented medication is one of the most effective strategies for severe OCD [2].
For people whose OCD has not responded to weekly outpatient ERP plus medication, intensifying ERP is often more useful than adding more medication. Research on intensive ERP daily or near-daily sessions across two to three weeks shows that the compressed format produces gains comparable to or sometimes greater than longer weekly courses, particularly for severe OCD.
Two formats are common:
- Day-care or intensive outpatient programmes: the person spends most of each weekday in structured exposure work and returns home in evenings.
- Residential programmes: 24-hour structure, full medication oversight, daily ERP, removed from the home environment that may be reinforcing rituals through accommodation. Especially useful when there is significant co-occurring depression, when home accommodation has been heavy, or when functional impairment is severe.
The Foa 2005 trial established that combination treatment, ERP plus medication, outperforms either alone for moderate-to-severe OCD, with response rates in the 70–85% range [2]. In refractory cases, that combination is often delivered in an intensive format.
Treatment Sequence at a Glance Here
| Treatment | Stage in sequence | Typical setting | Evidence base | Available at Abhasa |
|---|---|---|---|---|
|
Treatment
SSRI optimisation
|
Stage in sequence
Step 1
|
Typical setting
Outpatient
|
Evidence base
NICE CG31; APA Guideline
|
Available at Abhasa
Yes
|
|
Treatment
SSRI switching
|
Stage in sequence
Step 2
|
Typical setting
Outpatient
|
Evidence base
Pittenger 2021[5]
|
Available at Abhasa
Yes
|
|
Treatment
Antipsychotic augmentation
|
Stage in sequence
Step 3
|
Typical setting
Outpatient + monitoring
|
Evidence base
Bloch 2006 meta-analysis [9]
|
Available at Abhasa
Yes
|
|
Treatment
Intensive / residential ERP
|
Stage in sequence
Step 4
|
Typical setting
Day-hospital or residential
|
Evidence base
Foa 2005; Öst
2015 [2] |
Available at Abhasa
Yes (residential)
|
|
Treatment
TMS for OCD
|
Stage in sequence
Step 5 (selected cases)
|
Typical setting
Tertiary specialist centre
|
Evidence base
Carmi 2019; FDA 2018 clearance [10]
|
Available at Abhasa
No referral arranged
|
|
Treatment
DBS for OCD
|
Stage in sequence
Last-line, very severe
|
Typical setting
Multi-disciplinary surgical centre
|
Evidence base
Greenberg 2010; FDA HDE 2009 [10]
|
Available at Abhasa
No referral arranged
|
Procedural Treatments — TMS, DBS, and Ablative Surgery
QUICK ANSWER
When standard pharmacological and psychological treatments have not produced an adequate response after multiple adequate trials, procedural treatments may be considered. Transcranial Magnetic Stimulation (TMS) is the least invasive and is FDA-cleared for OCD.
Deep Brain Stimulation (DBS) is more invasive and reserved for very severe, treatment-resistant cases evaluated by multidisciplinary teams. Ablative surgery is rare and only considered in highly specialised settings [18]. These decisions belong with specialist psychiatric and neurosurgical teams, never first-line, never self-directed.
This section is written as “what these are, when they are considered, and who decides” not as “should you try them.” Procedural treatments for OCD are powerful and have a meaningful evidence base.
And they are not a step a family takes on their own. They follow a careful sequence, after multiple adequate trials of first-line treatment, and involve specialist evaluation.
Transcranial Magnetic Stimulation (TMS)
TMS uses focused magnetic pulses delivered through a coil placed on the scalp to modulate activity in cortical regions implicated in OCD. The deep TMS form approved for OCD targets the medial prefrontal cortex and anterior cingulate cortex circuit.
Treatment is typically delivered as brief daily sessions over 4–6 weeks. TMS for OCD received FDA clearance in 2018 in the United States and is available at specialised centres in major Indian cities. Side effects are usually mild (scalp discomfort, transient headache) seizure risk is small but real and is screened for before treatment.
TMS is generally considered when:
- OCD has not responded adequately to multiple adequate trials of SSRIs and ERP.
- The person prefers a non-medication option or cannot tolerate medication side effects.
- A specialist TMS centre with OCD-specific protocols is available.
Deep Brain Stimulation (DBS)
DBS involves the surgical implantation of electrodes in specific deep-brain targets (commonly the ventral capsule / ventral striatum) and a pulse generator under the skin. The electrodes deliver continuous, low-level electrical stimulation.
DBS for OCD received an FDA Humanitarian Device Exemption in 2009 and remains a treatment of last resort for very severe, multi-trial-resistant OCD. Trials report meaningful response in roughly 40–60% of carefully selected patients [18].
DBS is considered only after:
- Multiple adequate trials of SSRIs and clomipramine.
- Adequate trials of intensive ERP.
- Adequate augmentation trials.
- Comprehensive multidisciplinary evaluation by a team including psychiatry, neurology, neurosurgery, and clinical psychology.
- Informed consent that covers surgical risks (infection, bleeding, hardware complications), the need for ongoing programming, and uncertain individual outcomes.
DBS centres for psychiatric indications are limited in India. Tertiary academic centres are usually the referral pathway when this option is being discussed seriously.
Ablative Neurosurgery
Procedures such as anterior capsulotomy and anterior cingulotomy create small, permanent lesions in specific brain regions implicated in OCD. They have a long history and continue to be performed at a small number of specialist centres worldwide, including in India.
Ablative procedures are considered only in highly specialised settings, after every other option has been adequately tried, and require careful informed consent because the lesions are permanent. They are not part of routine OCD care.
What This Section Is Not
This section is not a recommendation, a comparison shopping list, or a self-directed pathway. The reason for naming these treatments is that families often hear the words and need a calm, evidence-anchored explanation of what they are.
The decision to consider any procedural treatment belongs with a multidisciplinary specialist team that knows the person’s full medical and psychiatric history.
Not sure where to start?
Our clinical team can walk you through what to expect — confidentially, with no obligation. info@abhasa.in or +91-73736-44444. We’re here to help.
When and How a Residential Programme Helps
For severe and treatment-resistant OCD, a residential programme often does several things outpatient care cannot:
- Daily intensive ERP delivered in protected time, removed from the home environment that may have been reinforcing rituals.
- Around-the-clock medication oversight during titration of higher-risk medications (clomipramine, augmentation agents) or during medication switches.
- Co-occurring condition management depression, anxiety, sleep, and substance use often need to be addressed alongside OCD.
- Family work teaching family members how to step out of accommodation patterns and support recovery without becoming part of the rituals.
- Step-down planning a structured pathway back to outpatient care, with clear maintenance plans.
From our clinical team at Abhasa: “What we see consistently is that families who have tried hard in outpatient settings often arrive here already knowing a great deal about OCD. The residential environment does not replace that knowledge — it gives it the protected time and intensity to actually work.” — Dr. R. Shree Aarthi, MBBS, MD, DNB(Psychiatry), Senior Consultant Psychiatrist, Abhasa Rehab and Wellness
At Abhasa Rehab and Wellness, residential OCD treatment is delivered by a multidisciplinary team — psychiatry led by Dr. Naveen Kumar (MBBS, DPM, 20 years) and Dr. Shree Aarthi (MBBS, MD, DNB), clinical psychology led by Ms. Meera K (M.Phil Clinical Psychology), and 24-hour residential medical staff.
Across the broader OCD treatment literature, intensive residential and combined programmes consistently report meaningful symptom reduction and functional improvement at six-month follow-up [1][2]. Specific recovery rates depend heavily on case mix, severity, and adherence — your treating team will share what is realistic for your situation.
Co-Occurring Conditions in Severe OCD
Severe OCD is rarely alone. The most common co-occurring conditions in this group are:
- Depression: often severe enough to interfere with ERP engagement.
- Anxiety disorders: generalised anxiety, panic, social anxiety.
- Substance use: alcohol, cannabis, prescription medication misuse.
In the Indian context, the AIIMS-NIMHANS National Mental Health Survey 2015–16 found that about half of people with OCD have at least one co-occurring psychiatric condition over their lifetime [9]. In severe and treatment-resistant cases, the proportion is higher.
Treating the co-occurring condition is not optional in severe OCD. It is often the variable that decides whether the next-line OCD treatment can work at all.
How Abhasa Approaches Severe and Treatment-Resistant OCD
At Abhasa, severe OCD is treated through a structured pathway that begins with a comprehensive multidisciplinary assessment, including psychiatric, psychological, medical, and social. The assessment identifies prior treatment adequacy, co-occurring conditions, family accommodation patterns, and functional impairment. From there, the treatment plan is built individually.
For most people, the pathway involves:
- Optimising medication first (correct agent, target dose, adequate duration).
- Intensive or residential ERP delivered alongside.
- Augmentation pharmacology when needed.
- Family work to reduce accommodation.
- Structured step-down planning.
Procedural treatments (TMS, DBS, ablative surgery) are not delivered at Abhasa. When they are appropriate after a careful trial sequence, referrals to specialist tertiary academic centres are arranged with full clinical handover.
A confidential psychiatric assessment is the first step, call +91-73736-44444 or write to info@abhasa.in.
Frequently Asked Questions
Treatment-resistant OCD is OCD that has not responded adequately to at least one to two adequate trials of first-line treatment usually defined as a 10–12 week SSRI trial at the OCD target dose plus an adequate course of ERP [3][5]. Different research groups use slightly different definitions, but the working clinical idea is the same: the standard treatment has been tried properly and has not worked enough.
About 30–40% of people with OCD do not respond fully to a first SSRI plus ERP per Pittenger et al. (2021), American Journal of Psychiatry [5]. The great majority of that group respond to one of the next-line options when the team has time to work through them carefully switching, augmentation, intensive ERP. A smaller subset eventually requires procedural treatments.
Yes. Transcranial Magnetic Stimulation (TMS) for OCD is available at specialised centres in major Indian metros. It received FDA clearance in the United States in 2018 and has gradually become more accessible in India through tertiary psychiatric centres. The Indian Psychiatric Society and individual centres can guide referrals. TMS for OCD is delivered as brief daily sessions over 4–6 weeks.
Deep Brain Stimulation (DBS) is a neurosurgical treatment in which electrodes are implanted in specific deep-brain targets and connected to a pulse generator under the skin. For OCD it received an FDA Humanitarian Device Exemption in 2009. Trials report meaningful response in roughly 40–60% of carefully selected patients [10]. Safety risks are real infection, bleeding, hardware complications and the procedure is reserved for very severe, multi-trial-resistant cases evaluated by multidisciplinary specialist teams. It is not a routine treatment.
There is no single “hardest” subtype. In clinical practice, people with significant mental compulsions (especially in Pure O and Harm OCD presentations), people with very long-standing OCD before treatment, and people with significant co-occurring depression or substance use often need more time and more intensive treatment. With the right pathway, almost all of these are workable.
For mild-to-moderate OCD, ERP alone produces response rates of 60–75% in adults completing a full course [1]. For severe OCD, the combination of ERP and medication is usually more effective than either alone [2], and most clinicians recommend offering combination treatment. Medication-free pathways exist for severe OCD but are less common and are usually a deliberate informed choice made with close clinical follow-up.
Closing — There Are More Doors Than the First Two
The most important message in this guide is that severe and treatment-resistant OCD is not the end of the road. It is a sequence careful, evidence-anchored, and worked through by a team that knows what each next step is for.
Most people who arrive in the treatment-resistant category eventually find a combination of options that produces meaningful and sustained improvement.
Severe and treatment-resistant OCD has more options than most families realise. Optimisation, switching, augmentation, intensive ERP, and when appropriate, procedural treatments form a sequence that reaches most of the people, first-line treatment alone does not. The work belongs with a multidisciplinary team. The journey is hard. The exit doors are real.
If you are weighing the next step for yourself or a family member, the most useful first move is a comprehensive psychiatric reassessment with a team that treats severe OCD regularly.
Ask for an honest review of what has been tried, what has not been adequate, and what the next-line sequence would look like, specifically for you.
A confidential psychiatric assessment is the first step. Call +91-73736-44444, write to info@abhasa.in, or visit the Admission Guide.
Talk to Abhasa’s clinical team — confidentially.
Call info@abhasa.in or +91-73736-44444. We’re here to help.
References
[1] Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review. 2015;40:156-169. — ERP response rates 60–75%.
https://pubmed.ncbi.nlm.nih.gov/26117062/
[2] Foa EB, Liebowitz MR, Kozak MJ, et al. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry. 2005;162(1):151-161. — Combined treatment 70–85% response.
https://pubmed.ncbi.nlm.nih.gov/15625214/
[3] National Institute for Health and Care Excellence (NICE). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. Clinical Guideline CG31. London: NICE; 2005 (updated). — SSRI 10–12 week adequate trial; ERP first-line.
https://www.ncbi.nlm.nih.gov/books/NBK608559/pdf/Bookshelf_NBK608559.pdf
[4] Pittenger C, Brennan BP, Koran L, et al. Specialty knowledge and competency standards for pharmacotherapy for adult obsessive-compulsive disorder. American Journal of Psychiatry. 2021;178(4):343-351. — Stepped sequence for treatment-resistant OCD; 30–40% non-response to first line, augmentation strategies.
https://www.sciencedirect.com/science/article/abs/pii/S0165178121001505
[5] Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. Psychiatric Clinics of North America. 2014;37(3):375-391. — Augmentation strategies; glutamate modulators.
https://pubmed.ncbi.nlm.nih.gov/25150568/
[6] Fineberg NA, Reghunandanan S, Brown A, Pampaloni I. Pharmacotherapy of obsessive-compulsive disorder: evidence-based treatment and beyond. European Neuropsychopharmacology. 2013;23(10):1325-1336. — Clomipramine 50–70% response.
https://pubmed.ncbi.nlm.nih.gov/23125399/
[7] Gururaj G, Varghese M, Benegal V, et al. National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity. International Journal of Social Psychiatry. 2020;66(4):361-372. — India OCD prevalence; co-occurring conditions.
https://pubmed.ncbi.nlm.nih.gov/32126902/
[8] Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS): I. Development, use, and reliability. Archives of General Psychiatry. 1989;46(11):1006-1011. — Y-BOCS standard severity measure.
https://pubmed.ncbi.nlm.nih.gov/2684084/
[9] Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Molecular Psychiatry. 2006;11(7):622-632. — Antipsychotic augmentation evidence base.
https://pubmed.ncbi.nlm.nih.gov/16585942/
[10] Greenberg BD, Gabriels LA, Malone DA Jr, et al. Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Molecular Psychiatry. 2010;15(1):64-79. — DBS for OCD long-term outcomes.
https://pubmed.ncbi.nlm.nih.gov/18490925/
[11] Dougherty DD, Brennan BP, Stewart SE, Wilhelm S, Widge AS, Rauch SL. Neuroscientifically informed formulation and treatment planning for patients with obsessive-compulsive disorder: a review. JAMA Psychiatry. 2018;75(10):1081-1087. — Neuroscientifically informed treatment planning.
https://pubmed.ncbi.nlm.nih.gov/30140845/
- Reviewed by
- Senior Consultant Psychiatrist
- Abhasa Rehab and Wellness
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