Case report: Pharmacotherapy and EMDR psychotherapy as an effective treatment for ocd imagery in a patient with a psychotic disorder

Unlike compulsive symptoms, such as washing hands, or obsessive symptoms, such as recurring thoughts of contamination, the issue of obsessive compulsive disorder (OCD) imagery receives little attention in the literature. This article describes the case of a 28-year-old male who was referred to a psychiatric day care department following complaints of intrusive imagery which he had sustained for more than a decade. The symptoms started after watching a video clip of decapitation on the internet. He also complained of intrusive thoughts with both aggressive and sexual contents. The Yale-Brown Obsessive Compulsive Scale and the Impact of Event Scale-Revised were used to assess his mental distress. During his stay in the day care department, he was diagnosed with a schizoaffective disorder and OCD. The patient was treated successfully with an antipsychotic medication for the psychotic disorder and concomitantly with selective serotonin reuptake inhibitors (SSRIs) and eye movement desensitization and reprocessing (EMDR) therapy for the OCD. This clinical case report supports the body of knowledge on the efficacy of EMDR as an adjuvant treatment to pharmacotherapy for OCD and, specifically, for OCD imagery. In addition, it supports the growing body of evidence of the beneficial effect of EMDR therapy among patients with psychotic disorders.