NEI Podcast E258 - The OCD Puzzle: Diagnosis, Treatment, and Innovation in Practice with Dr. Jeffrey Strawn
Jul 2, 2025
Dr. Jeffrey Strawn, a leading expert in psychiatry from the University of Cincinnati, dives deep into the nuances of obsessive-compulsive disorder (OCD) with Dr. Andy Cutler. They discuss the importance of accurate diagnoses and the misdiagnosis of OCD due to stigma. The conversation explores evidence-based treatments including SSRIs and innovative therapies like ketamine. They emphasize neuroplasticity's role in therapy and advocate for a focus on functionality in mental health treatment. The need for personalized approaches in care also shines through.
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OCD Often Hides in Plain Sight
- OCD is often underdiagnosed due to atypical presentations and comorbidities masking symptoms.
- It frequently hides in plain sight, misidentified as other anxiety or mood disorders.
Case of Hidden OCD in Depression
- A young man with treatment-resistant depression was later diagnosed with OCD after suicidality showed an ego dystonic pattern.
- Transitioning to fluvoxamine and CBT led to significant improvement and symptom remission.
Assess OCD Over Time
- Assess OCD by exploring repetitive, distressing intrusive thoughts and related compulsive behaviors.
- Revisit assessment over time to uncover symptoms patients may initially hide due to shame or guilt.