Behaviour Therapy for Obsessive Compulsive Disorder in a 78‐Year‐Old Woman

Objective. To describe a case of late onset obsessive compulsive disorder (OCD) and determine the impact of a behavioural intervention on OCD symptoms. Design. A single case design was undertaken in which the severity of the patient's OCD symptoms was measured before and after treatment. Setting. The intervention was undertaken in the patient's home. Patient. A 78‐year‐old woman with a history of depression who experienced sudden onset and rapid escalation of OCD following a domestic accident. Intervention. A behavioural procedure involving continuous in vivo exposure and response prevention over an 8‐hour period. Measures. The Y‐BOCS self‐rating scale (Yale Brown Obsessive Compulsive Scale) and clinical observation. Results. Y‐BOCS score improved from 35 prior to treatment to 12 post treatment (mean for OCD population=25.1; SD=6, Goodman et al., 1989). Improvement was maintained at 2 months follow‐up (Y‐BOCS=11). Improvements in confusion and agitation were also observed. Conclusions. This case study supports the use of behavioural interventions for elderly patients suffering from OCD. Risk factors and treatment designs are discussed in view of the literature. © 1997 by John Wiley & Sons, Ltd.