HeadsUp Grand Rounds Series: The Intersection of OCD and Psychosis: Implications for Assessment & Treatment

HeadsUp Presents: Up to 30% of individuals with psychosis also experience significant obsessive-compulsive symptoms (OCS). Co-occurrence of obsessive compulsive disorder (OCD) in the context of psychosis is common, yet understudied, and is associated with a more severe clinical presentation and course than psychosis alone. Differential diagnosis of these conditions is complicated by overlapping symptom presentations.  Identifying individuals experiencing OCD along with psychosis symptoms is important for determining who may be at risk for a more severe symptom course and for determining how to optimally intervene. This presentation will first present epidemiological data highlighting the rates of comorbidity of OCD with psychosis, what is known about why these symptoms may co-occur at such high rates, and the state of the literature with respect to psychopharmacological and psychotherapeutic treatment. Second, we will present key guidance for OCD assessment across the lifespan and special considerations for when there also may be concern for psychosis symptoms. Finally, we will discuss how and when exposure and response prevention (ERP), the leading psychosocial treatment for OCD, can be applied successfully to individuals with stable psychosis symptoms who are struggling with OCD symptoms. Case examples will illustrate principles discussed.

Objectives:
Explain the importance of understanding how OCD can present and how these symptoms can look similar to and different from psychosis symptoms.

Name strategies for assessing and differentiating OCD symptoms from psychosis symptoms.

Explain the theoretical principles of how exposure and response prevention can help those with psychosis and OCD symptoms reduce impairment associated with OCD symptoms.

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