What is Obsessive Compulsive Disorder (OCD)?
Compulsions may be directly related to an obsession (such as excessive hand washing due to the fear of contamination) or actions that are completely unrelated to the obsession.
This repetitive behavior significantly interferes with a person’s daily activities and social interactions.
Pregnant and postpartum women are more likely to experience OCD compared to the general population.
See Perinatal Mental Health Disorders for more information.
Obsessions cause distressing emotions (anxiety/fear/disgust), and while OCD sufferers recognise that these are a product of their mind and are excessive/unreasonable, the distress caused by these intrusive thoughts cannot be resolved by logic or reasoning.
Compulsions are repetitive acts that a person feels driven to perform ritually in response to an obsession. While this behavior typically reduces a person's obsession-related distress temporarily, in severe cases, they can make a normal routine impossible.
Diagnosing OCD
Penrose Health Action Plan
We aim to keep the number of Mental Health Nurse visits to a maximum of 6 per patient in any given episode. See Schedule of Reviews below for more specific/detailed guidance.
⚠️ Safety netting
If at any time a patient presents:
- with a significant change in risk status; or
- if there is a commencement/change in medication
The visit count resets back to the beginning (i.e. First review)
Secondary and External services may be better placed to help/support patients than we are.
- Secondary services offer psychological treatments (e.g., interpersonal/psychodynamic therapies, CBT)
- External services in the community offer many options for social and psychological help through relationships with the wider service network (e.g. Social Prescriber, Befriender, Care Coordinator, Therapist, Lifestyle Coach, etc.)
We do not provide any form of psychotherapy within our surgeries.
Patient Journey - Determining Schedule of Reviews
Click toggle for a schematic of the action plan/treatment policy for all Penrose Health Surgeries, or follow the guidance below.
Suspected OCD → consult with GP to agree next steps for patient management.
If required after discussion with GP, assess using appropriate screening tools and full patient history, including:
- childhood symptoms
- current vocational or social impairment
Perform thorough assessment for any concurrent diagnosis (e.g. Depression, Anxiety, ASD). If assessment/history is suggestive → rebook and follow that pathway.
Once patient assessed and GP consulted, the following treatment options will be considered:
- For severe OCD → consider referral to secondary services for for more intensive Cognitive Behavioral Therapy (CBT) and management
- For mild OCD → management in primary care may include:
- GP referral to IAPT or other psychology for CBT
- GP initiation of medication.
If starting medication → review 2-3 weeks.
If no medication → review in 4-6 weeks.
- If a patient is actively managed by another mental health provider → liaise with services as required and conclude routine MHN appointments.
- If rejected by secondary services and patient is at high risk → review again in <1-2 weeks.
If patient being managed in primary care → assess response to meds/self-help and discuss with GP regarding ongoing plan.
If patient still requiring care → consider GP assuming management of patient.
Referring/Signposting Onward
Below are some services to which you can signpost/refer patients. More services can be found on the Penrose Portal in Mental Health Services Database.