Towards Personalized OCD Treatments? New Research Brings Hope

August 31st, 2020

Awake Goy

August 31st, 2020

For the millions of people around the world suffering from OCD, new research may bring a ray of hope – scientists are learning more about how to tell what kind of therapy will work best for any given individual.

OCD – obsessive compulsive disorder – is a highly debilitating disorder in which an individual has recurring unwanted thoughts or behaviors which they feel compelled to perform. 50% of adults with this condition find their daily lives severely impaired by it [1] – compulsive behaviors can take up hours each day, reducing the individual’s ability to live a normal, satisfying life. OCD regularly leads to severe anxiety or depression, and people with OCD often find their relationships suffering too. People with OCD may isolate themselves, suffer from internal and external anger, and physical exhaustion ^[1].

The most common method of OCD treatment currently is a combination of medication and talking therapy such as CBT (cognitive behavioral therapy). However, such interventions are only effective for 7 out of 10 patients – and of those 7, a full 50% will eventually stop taking their medication due to severe side effects ^[1].

Hope from New Research

Researchers at the University of Michigan are in the early stages of being able to predict which of two types of therapy will best help any given individual. The two types of therapy involved are:

Exposing the individual to the subject of their thoughts or behaviors or
A stress reduction and problem-solving approach

Research published in The American Journal of Psychiatry involved taking detailed brain scans from 87 adults and teenagers who had been diagnosed with moderate to severe OCD. Each of the test subjects was randomly assigned to 12 weeks of one or other type of therapy.

The results showed that both types of therapy were effective to a certain degree, and both reduced OCD symptoms in participants. Overall, exposure therapy was found to be more effective in the longer term – something which had previously been suspected ^[2].

However, the real breakthrough in the research came when examining the pre-treatment brain scans of individuals and linking them to individual responses to therapy. Researchers were able to do discover that the more brain activity a subject had in certain brain areas, the more likely they were to respond best to exposure therapy ^[2].

Activity in Different Brain Areas

The brain areas important in OCD had already been identified and are being used in a different emerging therapy, transcranial magnetic stimulation. However, the discovery that activity in these brain areas could pinpoint the best treatment for an individual is a new and important step forwards.

During the brain scans in this research program, participants were asked to choose the correct letter from a display of letters, and they were told they would receive a small monetary reward for performing it correctly.

Subjects who responded well to exposure therapy showed strong brain activity in the brain’s cinguloopercular network when selecting the letter, and strong activity in the orbitostriato-thalamic network when contemplating the reward for the test task. Those with lower brain activity in these areas during the test task, however, responded better to stress reduction therapy. These effects were consistent across both adults and teens and did not vary with age ^[2].

Among those subjects who responded well to exposure therapy, researchers also found strong pre-treatment brain activation in areas of the brain associated with dealing with fear ^[2].

Taken together, these findings cause researchers to hypothesize that stronger reward motivation and stronger ability to face fear may be key in a patient who will respond to exposure therapy – since this therapy involves being confronted with their OCD triggers and can be an uncomfortable process.

Can OCD Treatment Be Personalized?

It would be impractical to perform brain scans on every OCD patient, but this new research does suggest that easily administered behavioral tests could help in determining which treatment to recommend to patients. Those who show most cognitive control and reward responsiveness could be pointed towards exposure therapy, while others could be recommended to stress reduction techniques, mindfulness and problem-solving training.

The current research involved only teens and adults, so it remains to be seen whether a similar distinction can be made when choosing treatments for children with OCD. The University of Michigan team are currently recruiting children with OCD for a clinical trial along similar line, to include brain scanning before and after treatment.

Although still in its early stages, this research does suggest hope on the horizon for the millions of people with OCD for whom their current treatment is either not working at all, or for whom interventions did work but were later abandoned. For those suffering from this cruel and much misunderstood condition, and their loved ones, such news cannot come soon enough.

References:

About the author:

Nikki Harper is a spiritualist writer, astrologer, and Wake Up World’s editor.