Modern Treatment for OCD May Have Prevented Hughes' Seclusion

Since the death of Howard Hughes, OCD treatment advances save others from similar fate

December 20, 2004

Adriana Bobinchock
Cindy Lepore
Public Affairs

Belmont, MA - When the film "The Aviator," starring Leonardo DiCaprio as Howard Hughes, opens in theaters this week, audiences around the world will be introduced or reintroduced to the eccentric billionaire. They will see Hughes' love of flight, his courtship of women, the power of his money, as well as his struggles with obsessive compulsive disorder (OCD).

OCD is a type of anxiety disorder, in which time-consuming obsession and compulsions significantly interfere with a person's routine, making it difficult to work or to have a normal social life or relationships. There are many symptoms of the illness, called behaviors, including cleaning, repeating, completing, checking, being meticulous, avoiding and hoarding. Individuals with OCD can exhibit any number of these symptoms, as well as other varieties of compulsions, including excessive and ritualized praying, counting and list making.

Hughes' illness manifested in his inability to leave his home and an overwhelming fear of being contaminated by germs, leading him to live as a recluse. Although his symptoms were moderate in the beginning, by the time he died in 1976, because of a lack of effective treatment, the illness left him debilitated.

In the years since Hughes' death, there have been many great strides made in understanding and treating OCD. Today, Hughes could be treated with new medications and therapy that would enable him to lead a healthy and productive life.

"Thirty years ago, OCD was a rare diagnosis and those who had it were considered eccentric," said Michael Jenike, MD, medical director of the Obsessive Compulsive Disorders Institute at McLean Hospital (OCDI). "Today, four million Americans have been diagnosed with the illness, but the good news is that it can be effectively treated through a combination of medication and behavioral therapy."

For instance, says Jenike, treating someone like Hughes requires a stay for several weeks in a residential treatment setting, such as the OCDI, where the person can work one-on one in treatment sessions with a behavioral therapist to identify target obsessions, compulsions and avoidance behaviors. Once the behaviors are identified, the individual and therapist can begin response-prevention exercises.

"During these treatment sessions, patients are asked to gradually expose themselves to things that they fear and thus they gradually learn to control their anxiety," explains Jenike. "Response-prevention exercises have proven extremely effective in treating OCD."

In addition to behavior therapy, individuals with OCD are often treated with medication. Selective serotonin reuptake inhibitors (SSRIs), including Prozac, Paxil, Luvox, Celexa, and Zoloft, are often successful in treating OCD.

"If we had these medications and a better understanding treatment three decades ago, Hughes' OCD would have been treated and people would be more apt to remember him as a pioneer rather than as the eccentric billionaire who shut himself away from the world," said Jenike.

McLean Hospital maintains the largest research program of any private, U.S. psychiatric hospital. It is the largest psychiatric clinical care, teaching and research facility of Harvard medical School, an affiliate of Massachusetts General Hospital and a member of Partners HealthCare System.

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