Exposure and Response Prevention for Comorbid Symptoms of Obsessive-Compulsive Disorder and Psychogenic Movement Disorder.

Psychogenic movement disorders (PMDs) are common, associated with significant psychosocial impairments, and frequently comorbid with other physical and psychiatric conditions. However, treatment of PMDs has been largely unsuccessful. Recently, treatments focused on conditions comorbid with PMDs have been hypothesized as a possible improvement to PMD-focused treatments. This case report describes a patient initially diagnosed with a PMD and referred for psychotherapy after appointments with neurologic and psychiatric providers. Upon referral to psychotherapy, the patient received a diagnosis of comorbid obsessive-compulsive disorder (OCD) and treatment with exposure and response prevention (ERP), an evidence-based psychotherapy for OCD. The patient demonstrated reliable improvements in all self-report measures as well as remission of PMD and OCD symptoms via behavioral observation at the end of therapy and at a 1-month follow-up. This case presents initial support for the treatment of comorbid and overlapping conditions in patients with PMDs, providing a pilot demonstration to support future large investigations.