On Demand Grand Rounds: Approaches to Treatment Resistant OCD
Wolfe Adler Award Lecture
This presentation was originally reviewed on October 10, 2022, and broadcast live online on October 12, 2023, from 11:30 AM – 1:00 PM ET.
The views and opinions expressed by this presenter in this lecture are their own, and do not represent the views of Sheppard Pratt.
Obsessive-compulsive disorder is common, persistent (in the absence of therapy), and oftentimes disabling. About 30-40% of patients fail to respond sufficiently to first line treatments of exposure and response prevention (ERP) and serotonin reuptake inhibitors (SRIs). Adjunctive antipsychotics are the only established second line pharmacological approach. This presentation will focus on adult patients with severe and chronic OCD who have exhausted a wide range of available therapeutic options. Deep brain stimulation (DBS) targeting the ventral capsule/ventral striatum is approved by the FDA under a humanitarian device exemption (HDE) for intractable OCD. The presentation will include a review of the literature on outcomes with DBS, discussion of inclusion/exclusion criteria, description of the implanted devices and surgical procedures, and Dr Goodman’s experience with conducting DBS programming. Preliminary findings from an NIH funded study to develop closed-loop DBS for OCD will be presented.
Target Audience
This activity is intended for physicians, nurses, psychologists, social workers, counselors and other mental health professionals.
Learning Objectives
At the conclusion of this activity, attendees will be able to:
- Define treatment resistant OCD for DBS eligibility.
- Name brain regions targeted by DBS for OCD.
- Explain some of the exclusion criteria for DBS in OCD
Sheppard Pratt’s Professional Education Program is pleased to provide Wednesdays at Sheppard Pratt free of charge as a public service to the mental health community. Your tax-deductible donations will help maintain the outstanding quality of this service.
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Sheppard Pratt regularly hosts renowned speakers from across the country at our headquarters in Towson. We provide educational opportunities on subjects including psychiatric disorders, issues of behavioral health, systems-based change, mental and somatic co-morbidities, psychiatric effects on health and health outcomes, advances in neurobiology, and clinical developments in concepts underlying drug treatment of psychiatric disorders. We are accredited by the Accreditation Council of Continuing Medical Education, the Maryland Nurses’ Association, the Maryland Board of Psychology, the Maryland Board of Social Work, and the National Board of Certified Counselors.
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About the speaker
Wayne Goodman, MD, D.C and Irene Ellwood Professor and Chair of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, specializes in Obsessive-Compulsive Disorder (OCD) and Deep Brain Stimulation (DBS) for intractable psychiatric illnesses. He is the principal developer of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the gold standard for assessing OCD, and co-founder of the International OCD Foundation, the major advocacy group for patients with OCD. Prior to joining Baylor, he held senior administrative positions at Mount Sinai Hospital in NY, NIMH, and the University of Florida. He graduated from Columbia University with a degree in Electrical Engineering, received his medical degree from Boston University School of Medicine and completed his internship, residency, and research fellowship at Yale School of Medicine where he remained on faculty for 7 years. He was elected member of Association of American Physicians, Distinguished Life Fellow of the APA, and Fellow of the ACNP. Dr. Goodman has received numerous awards and has published over 300 peer-reviewed articles with an h-index = 100. He is currently a Principal Investigator on grants from NIH’s BRAIN initiative including one on developing Adaptive DBS for OCD.
Disclosure Statements
Sheppard Pratt holds the standard that its continuing medical education programs should be free of commercial bias and conflict of interest. In accord with Sheppard Pratt's Disclosure Policy, as well as standards of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA), all planners, reviewers, speakers and persons in control of content have been asked to disclose any relationship he /she has with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months. All planners, reviewers and speakers have also been asked to disclose any payments accepted for this lecture from any entity besides Sheppard Pratt, and if there will be discussion of any products, services or off-label uses of product(s) during this presentation.
Wayne K. Goodman, MD, reports that he is a consultant for Biohaven. He will discuss DBS and TMS devices as well as off-label augmentation agents for OCD. He will not discuss any products or services during this presentation, except in their generic form. All relationships have been mitigated. This presentation will focus on research.
Event Planners/Reviewers Disclosures: The following event planners and/or reviewers are reported as having no financial interest, arrangement or affiliation with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months: Todd Peters, MD, Deepak Prabhakar, MD, Elizabeth Ryznar, MD, MSc., Louis Marino, MD, Ehsan Syed, MD, Devi Bhuyan, PsyD, Faith Dickerson, PhD, Carrie Etheridge, LCSW-C, Tom Flis, LCPC, Laura Webb, RN-BC, MSN, Stacey Garnett, RN, MSN, Octavia Coit, MN, Heather Billings, RN, Lisa Illum, MLIS, MEd, and Jennifer Tornabene.
Physician Statement: Sheppard Pratt is accredited by The Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. Sheppard Pratt designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurse Statement: Sheppard Pratt is approved as a provider of nursing continuing professional development by the Maryland Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CME activity. This activity provides 1.5 contact hours for nurses.
Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. Sheppard Pratt designates this educational activity for a maximum of 1.5 contact hours for Psychologists.
Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this CE activity. This activity is approved for 1.5 contact hours in Category II credits for Social Workers.
Counselor Statement: Sheppard Pratt has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 5098. Programs that do not qualify for NBCC credit are clearly identified. Sheppard Pratt is solely responsible for all aspects of the program. This activity is available for 1.5 NBCC clock hours.
Available Credit
- 1.50 ACEP NBCC clock hours
- 1.50 AMA PRA Category 1 Credit™
- 1.50 Category II credits for Social Workers
- 1.50 Psychologists
- 1.50 MNA Contact Hours for Nurses
- 1.50 Participation
ON DEMAND WEBINAR: FOR BEST RESULTS WATCH USING GOOGLE CHROME
Grand Rounds: Approaches to Treatment Resistant OCD
Wayne K. Goodman, MD
D. C. and Irene Ellwood Professor and Chair, Menninger Department of Psychiatry and Behavioral Sciences,
Adjunct Professor, Baylor College of Medicine
Department of Electrical and Computer Engineering, Rice University
Houston, TX
Originally reviewed October 10, 2022.
Originally broadcast live October 12, 2022, from 11:30 AM – 1:00 PM ET
Enduring Activity Credit Expiration Date: December 25, 2025.
Activity Time: Ninety-minute webinar lecture with a 15-minute evaluation process. Total Time: 1:45.
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