Posted: December 29th, 2022
Obsessive compulsive disorder describes an anxiety disorder. It is characterized by recurrent, unwanted ideas, sensations or thoughts (obsessions) and/or repetitive behaviors (compulsions). These obsessions and compulsions affect personal relationships, work and school life aspects. This paper examines the HPI and clinical manifestations, treatment, medical management needs, community support resources and follow-up for a patient with obsessive compulsive disorder.Obsessive-Compulsive Disorders.
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HPI and clinical impression
The client, Dan, is a 25 year old gay male patient who presents to the clinic seeking treatment for anxiety.He works an editor and is also a part-time university student. He claims that he is fearful of being infected with HIV and other sexually transmitted infections which cause him increased anxiety. His presence was accompanied by a strong disinfectant smellsuggesting unique cleaning behaviors which he confirmed to having. These were associated with his concern of contracting HIV. He also reports that he avoided getting into contact with the things outside of his home and he cleans his hands using bleaches if he suspects that he had touched any item that is contaminated. He spends time washing his hands with disinfectants and could repeat the routine for more than 30 times daily. This has had a significant impact on his professional, social and academics performance due to lack of concentration as he spends most of the time cleaning his hands.Obsessive-Compulsive Disorders.
The client is currently under no medication. He presents a depressed mood, has intact memory and is well groomed. According to the DSM-5 criteria for OCD, patients should exhibit recurrent behaviors and persistent thought with which they suppress through other thoughts or actions and hence the client suffers from the illness (American Psychiatric Association, 2013).Obsessive-Compulsive Disorders.
The pharmacological approaches towards OCD seek to manage the symptoms. In this case, the client will be treated using the serotonergic antidepressants which are FDA approved as first line of treatment of OCD. Clomipramine and selective serotonin reuptake inhibitors (SSRIs) will therefore be prescribed for at least 3 months to achieve efficacy and tolerance. These medications help in the management of anxiety and thought processes as they affect the activities of the brain chemicals. The treatment is expected to restore the normal thoughts, reduce anxiety, compulsions and obsessions of the client. According to Stahl (2014), Clomipramine is an effective option for the treatment of panic disorder and obsessive compulsive disorder.Obsessive-Compulsive Disorders.
Pharmacological approaches are considered the most effective interventions to virtually all mental conditions. Cognitive Behavior Therapy (CBT) seeks to change the behaviors, ideas, thoughts and behaviors as well as attitudes of an individual (Gabbard, 2014)). The patient can be treated using cognitive behavior therapy to treat his symptoms and help him cope with the illness and management. Family therapy will help provide him social support which will be essential in changing his behavior and attitudes towards contracting HIV. Moreover, individual therapy will be used to enlighten the client on HIV, the risks associated with his sexual orientation and the prevention ways to ensure that he remains safe. He will also learn how to manage his obsessions and compulsions and as well know how to identify them. Group therapy will also him to gain exposure and knowledge regarding HIV and as well improves his relationship patterns with other people without fear of physical contact.Obsessive-Compulsive Disorders.
Medical Management needs
Medical management needs describe the sets of activities that support patient care and decrease the need for medical services. They help caregivers and primary care providers in the management of the patient’s health conditions. In order to optimize the client’s recovery, the collaboration between the mental health provider and the primary care provider will be necessary. It will help share information regarding the client’s health and the progress of the recovery as well as the challenges encountered during treatment. On the other hand, the healthcare providers will ensure monitoring of medication to prevent medical errors. This will help in obtaining the tolerance doses through electrolyte monitoring (Sadock, Sadock and Ruiz, 2014).Obsessive-Compulsive Disorders.
The involvement of the community in maintaining mental health is essential in the contemporary society. Communities set up diversified resources to help mental patients including housing inform of rehabilitations and nursing homes as well as meet the social economic needs of the patients including paying the hospital and medical bills for them.The patient will thus benefit from reduced hospital bills through community mental health insurance. Community agencies that support reproductive and mental health will also be significant to acquiring health education, knowledge and awareness regarding HIV and unhealthy sexual behaviors associated with homosexuality that could result in his infection other than what he previously perceived.Obsessive-Compulsive Disorders.
Follow up plan
The client will be given weekly appointments during the first month of treatment to monitor his progress with the current treatment. In the event of positive outcomes, follow up sessions will be scheduled once every month. However, the client can visit the clinic anytime if the symptoms worsen or drug intolerance occurs. Consequently, the client can carry out inquiries and consultations through mobile phone calls, SMS or email.Obsessive-Compulsive Disorders.
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