|
|
 | |||
|
|
|
|
| |||
 | |||||||||||||||||||||||||||||||||||||||
 | |||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A 33-year-old woman presents with a seven-year history of hand washing for two to six hours a day, as well as urges to check doors and stoves extensively before leaving her home. Her life is restricted, and her family members are upset about her behavior. How should she be evaluated and treated?
The Clinical Problem
This vignette describes a typical patient with an anxiety disorder
Strategies and Evidence
Diagnosis
Treatment
Cognitive–Behavioral Therapy
Initial Drug Treatment
Augmentation of Serotonin-Reuptake–Inhibitor Therapy and Trials of Alternative Drugs
Neurosurgery
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Psychiatry, Massachusetts General Hospital, Boston; McLean Hospital, Belmont, Mass.; and Harvard Medical School, Boston.
Address reprint requests to Dr. Jenike at jenike@comcast.net.
This article has been cited by other articles:
HOME | SUBSCRIBE | SEARCH | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | PRIVACY | TERMS OF USE | HELP | beta.nejm.org Comments and questions? Please contact us. The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved. |
Previous
