[Epidemiology and health care situation of obsessive-compulsive disorders]. / Epidemiologie und Versorgungssituation von Zwangsstörungen.

Obsessive-compulsive disorders are with a 12-month prevalence of up to 1% and a lifetime prevalence of 1-2% among the more common mental disorders. This is, however, neither reflected in the health care utilization of patients nor in the daily practice of psychotherapists, where obsessive-compulsive disorders still do not seem to play a major role. Due to feelings of shame, patients often tend to conceal their obsessive-compulsive symptoms. Furthermore, besides deficits in the health care situation for this disorder, treatment practice is not satisfying as well. Current guidelines recommend exposure and response prevention as the psychotherapeutic intervention of choice. Although this treatment has proved to be effective, it is still underutilized in psychotherapeutic routine care.Lack of experience or training on the part of therapists as well as insufficient information about the disorder and treatment possibilities on the part of patients contribute to the existing insufficient and inappropriate health care situation. Further education for therapists as well as more information for patients may help to sensitize them to this disorder and therefore increase the prognosis considerably.

[Psychotherapy for obsessive-compulsive disorder: what is evidence based?]. / Psychotherapie der Zwangsstörung : Was ist evidenzbasiert?

Obsessive-compulsive disorder is a severe, very disabling condition that usually takes a chronic course if no adequate treatment is applied. Up to now, cognitive behavioural therapy with exposure and response prevention (CBT) is the most thoroughly investigated and most effective intervention, leading to a clinically significant symptom reduction in 60-70% of the patients. Correctly applied, this treatment can be equally effective as its combination with pharmacological management. For a correct implementation, however, several points have to be considered which are described in the following review. Considering the fact that some of the patients are unable to benefit sufficiently from this approach, potential alternatives and extensions of CBT are discussed. To date, however, no other treatment approach has proven to be effective based on randomised controlled trials.

Cognitive dysfunction and subjective complaints of cancer patients. a cross-sectional study in a cancer rehabilitation centre.

Although the neurotoxicity of many anticancer therapies is well documented, the impact of cancer treatment on cognitive functioning has been studied less frequently. The present study examines deficits in cognitive functioning and their correlation with medical data as well as with psychosocial variables. A standardised neuropsychological test battery and several questionnaires were administered to a random sample of 119 patients. 24% of our patients fulfilled our criterion for cognitive impairment. There were no significant associations between the results of the neuropsychological testing and the current affective status or self-reports of attentional deficits in daily life. Cognitive impairment occurs in a clinically relevant percentage of cancer patients and cannot be explained exclusively due to depression or anxiety. Since subjective and objective cognitive impairment data showed little correlation, neuropsychological evaluation should not only be based on subjectively-reported complaints, but also on objective measurements.