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Evaluation and Treatment Planning

General Aspects of an Evaluation

A comprehensive clinical evaluation is necessary for deciding upon appropriate treatment. The evaluation for someone with obsessive compulsive disorder (OCD) does not differ greatly from that used for any general psychiatric evaluation, and the principles described here can be similarly applied to other OC disorders.

The evaluation needs to focus on the history of present illness, co-occurring mental and physical health issues (see each disorder for the specific co-morbidities), a review of medical and mental health systems, medication, family and social histories, and current mental status examination.

Other general questions that help with the assessment of OCD and related disorders also apply to psychiatric evaluations:

  • • What prompted the person to present for an assessment now?
  • • What are the expectations of the patient?
  • • What is the patient’s knowledge concerning their condition?
  • • How has the condition affected the person’s life? How has the condition affected other people in the patient’s life?
  • • Are there conditions, both medical and psychological, that co-occur with the presenting issue?
  • • What previous treatment approaches has the person tried? If they have received previous treatment, what was their feeling about these treatments?

During the evaluation, it is also appropriate to tell the patient:

  • • What you see the goal of treatment being;
  • • How you plan to measure change during treatment; and
  • • What you expect of the patient

Suicide Risk

Evaluate suicide risk in all patients. Individuals with OCD and related disorders may become overwhelmed by their obsessions and their inability to function normally, prompting suicidal ideation and behaviors. Some OC related disorders, such as Body Dysmorphic Disorder (BDD), show very high rates of suicidality.

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