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The outpatient treatment of patients with obsessions alone is often said to be less successful compared to the outpatient treatment of patients with both obsessions and compulsive symptoms. This article presents the outcome of the treatment of 26 obsessive patients. The success rate, measured after 10 treatment sessions, was 73%. At follow-up after 12-36 months, improvement appeared to have been maintained or to have increased in 61.5% of the patients, figures comparable to the outcome of patients with both obsessions and compulsions.

Eleven patients with obsessive thoughts were treated in two pilot studies. In the first of these patients were given thought-stopping, and this was contrasted with relaxation therapy. In the second study patients were treated by a technique described here as 'satiation', and this was followed by thought-stopping and finally a course of amitriptyline. The overall results were poor, but one type of obsessive thought responded well to satiation.

The goals of treatment need to be decided on the basis of knowledge on the nature of autism. As with any developmental disorder, the first goal must be to foster normal development; with autistic children this involves a focus on intellectual, language and social development. The further goals include: the reduction of rigidity/stereotypy; the elimination of non-specific maladaptive behaviours; and alleviation of family distress. Research findings are used to translate these goals into a practical overall therapeutic programme with three main elements: a full diagnostic appraisal, special educational provision and a home-based programme for the family. Finally, the research findings are drawn together to derive inferences on the lessons to be learned and the questions that remain to be answered.

Treatment with atropine in comatose doses was given to 11 patients suffering from schizophrenia with obsessive disturbances. A favourable effect was noted when there were no hypochondriacal symptoms in the disease clinical picture. Twenty-two patients with neurotic states received atropine in non-comatose doses. Positive results were noted in patients with obsessions in the disease clinical picture, as well as in patients with reactive depressions. In patients with hypochondriacal disturbances, this form of the therapy appeared to be of no effect.

Successful treatment of Tourette's syndrome in a young man seemed to precipitate anorexia nervosa. The obsessional behaviors associated with Tourette's syndrome and the social isolation incurred by his illness may have predisposed this patient to the development of anorexia nervosa in response to the heightened anxiety of adolescence. The association between obsessive-compulsive behavior and Tourette's syndrome is described, as is the diagnostic difficulty posed by the somatic obsessiveness of males with anorexia nervosa. The importance of using the biopsychosocial model to integrate pharmacologic therapy and psychotherapy in treating complicated conditions, as illustrated by the patient, is emphasized.