About obsessive compulsive disorder

Obsessive compulsive disorder affects around 2-3% of the general population. Fear of several objects characterizes the disorder. In the case depicted, the patient has demonstrated a fear of germs and infections, which is reflected in her regular hand washing. The problem interferes with an individual’s normal functioning since they tend to engage in an activity that will assist them overcome their fear. The analysis focuses on discussing the ailment, its prevalence, origin, and symptoms. Finally, a disease intervention is presented, with a focus on both therapeutic and pharmaceutical treatment.  A significant percentage of individuals experience irrational fear arising out of concerns for germs and diseases. The effect is an increase in anxiety. The condition has been medically described as mysophobia which is a term that illustrates the fear of germs. Persons who suffer from the disease are likely to depict a high degree of concern toward germs and end up washing hands frequently in the hope of protecting themselves from suffering from the flu. The focus of this discussion is to demonstrate the condition which is obsessive compulsive disorder causing the thoughts about germs and cleanliness hence the portrayed anxiety. The paper will illustrate the signs and symptoms of the condition, prevalence, etiology, therapeutic interventions and the pharmacological measures available to address the situation. The discussion will be based on information available in scholarly articles. The topic is of fundamental significance since it provides detailed information about the condition and how it can be addressed. It is an interesting subject of discussion because of the fact that the condition is rarely discussed. Further, individuals who suffer from the condition can be considered as being clean or perfectionists. The fact that it is a medical condition negates the need to understand it in detail. The analysis is essential since it will provide crucial insights as to the reason why those affected behave in the manner they do. The analysis will be based on case study of Carrie, a 12-year-old African-American who is affected by the condition.

Case Example Symptoms and Diagnosis

Carrie experiences frequent thoughts of germs and cleanliness. The situation is compounded by the fact that she feels anxious. In order to calm herself, she tries to maintain cleanliness by washing her hands to avoid the possibility of being affected by the germs. The manifestation of the disease is an irrational fear of germs that is depicted differently by various individuals. An individual may be fearful of a given disease while another could be afraid of the germs in general. In the case described by Carrie, she appears to have a phobia for germs in general, and this explains the anxiety that she feels.

The symptoms represented by Carrie include compulsive hand washing which she does almost 20 times a day in a bid to ensure that she is frequently clean. Further, the restless nature of the patient can be attributed to the fact that she is concerned about the possibility of contracting disease hence the manner in which she behaves. The urge to constantly engage in hand washing arises because the affected patient is fearful of germs. The condition can equally be described as a compulsive obsessive disorder. There is no easy test to diagnose the condition. However, the diagnosis significantly depends on observation of the identified signs and symptoms. It is critical to identify particular patterns that are essential in indicating that the disorder is full-blown. Some of the symptoms have been illustrated by the affected patient which includes persistent hand washing. Further, there is the aspect of compulsive cleanliness as depicted by the 12 year-old-patient. The patient would engage in consistent washing in a bid to ensure that they get rid of the feelings of anxiety. This is reflected by the patient’s condition which entails opting to wash her hands consistently to get rid of the feelings of anxiety. As indicated, the diagnosis relies on observation of the behavior of the patient.

Prevalence, Etiology, and Additional Symptoms

Prevalence

According to Melin, Skärsäter, Haugland and Ivarsson (2015), a naturalistic survey conducted indicated that 33% of adolescents were suffering from the obsessive compulsive disorder. The participants of the study entailed a total of 109 children all who were aged between the age of 7 to 17 years who had been initially diagnosed with OCD. Children who were diagnosed with the condition were at a high risk of suffering from chronic disease. Studies conducted by Jaisoorya et al. (2015) indicated that the prevalence of obsessive-compulsive disorder was high among the Muslims and this increased with one’s age. However, the researchers were able to illustrate the specific factors related to their obsession. According to Bennet (2016), the prevalence of OCD has been estimated to be about 2-3%. The researchers reiterate that the thoughts were then considered to be unrealistic especially amongst those affected by the condition. Different studies conducted by Niranjan and Swayamprava (2015) have demonstrated that the condition also affects about to 2-3% of the individuals in a population. The findings of the researchers agree with those illustrated by Bennet (2016) who indicated that a similar percentage of individuals in the population were affected by the condition. Further Niranjan and Swayamprava (2015), further affirm to the fact that OCD is the fourth most common mental health illness that affects patients. Similar studies conducted by Arya and Soodan (2016) demonstrate that the prevalence of the disease is 2.5% of the population and it is identified as one of the most debilitating mental illness. The evaluation of the different studies is a confirmation of the fact that there is a general prevalence rate of about 2-3% of the patients affected by the condition.

Etiology

Obsessive compulsive disorder remains to be one of the most critical mental health illnesses affecting a particular percentage of patients across the globe. Significant research has been directed toward describe the condition in detail. However, the studies have not been entirely successfully in illustrating the primary causes of the disorder. A report by the World Health Organization on mental health estimated that OCD was a leading cause of illness-related disability across the globe for individuals aged between 15-44 years (WHO, 2001). Studies have however shown that the development of OCD can be attributed to the fact that it has a neurobiological foundation. Notably, patients diagnosed with the condition tend to show different brain functions compared to those without. Researchers have shown that an imbalance in the neurotransmitters could be involved in the development of obsessive-compulsive disorder. Research has equally shown that the condition which affects mostly children is common in boys compared to the girls. Despite the fact that the condition affects females, those suffering from the same experience the onset of the symptoms at a later time. The trigger for the development of OCD can be linked to a combination of various factors including genetic, behavioral, neurological, cognitive and environmental factors (Dell’Osso, Benatti, Altamura & Hollander, 2016). Carrie, a 12-year-old depicts signs of behavioral problems, and this can serve to explain the manner in which she behaves. Further, in highlighting the behavioral cause of OCD. According to the behavioral theory, individuals suffering from OCD have associated themselves with particular objectives or a situation defined by fear. Carrie, who is suffering from the condition is fearful of germs and disease, and this is depicted by the frequency of thoughts she is facing. The effect is manifested in her opting to wash her hands consistently.

The behavioral theory further indicates that the affected individuals would try to learn on how to avoid the things causing the fear or engage in the performance of a particular ritual in a bid to get rid of the thoughts causing the fright. Indeed, this is equally depicted by Carrie who is bothered by the presence of germs. Despite the fact that she thinks her thoughts are logical, the manner in which she behaves is worrying. Her aunt, whom she lives with is concerned with the behaviors portrayed by Carrie. Specifically, there are concerns regarding Carrie’s emotional well-being and the frequency with which she is washing her hands. The way in which she consistently washes her hands can be viewed as excessively frequent. This can help explain the reasoning presented by the behavioral theory. The behavior depicted by Carrie can be that which focuses on dealing with her fears by avoiding what is likely to bring the fear that she was facing.

However, it is critical to indicate that there are cognitive causes of OCD. Primarily, this focuses on the manner in which an individual suffering from the condition tends to misinterpret their thoughts. In relating this to the case study, it could be that Carrie is behaving the way she is because of a misinterpretation of her thoughts. According to her, she thinks in a logical manner but only worried about the fear she has of germs and disease. This can explain the behavior that is depicted by Carrie.

Additional Symptoms

The additional symptoms reported for patients suffering from OCD are varied. Specifically, patients with the condition describe a variation in the degree of severity of the symptoms, but generally, the condition worsens with age. The persons affected by the condition could either experience the obsessive thoughts alone or engage in a compulsive behavior. In the case study depicted, there is both obsession and compulsive behavior. Carrie is obsessed with the whole idea of germs and disease. This is compounded by her opting to regularly engage in washing her hands, close to 20 times in a day. Individuals suffering from the condition may sometimes be embarrassed from the same and tend to hide while others display the problem outwardly.

Other symptoms that have been reported by individuals suffering from the condition are the existence of intrusive thoughts which in most cases is accompanied by the need not to have such ideas. Normally, the thoughts are disturbing and not wanted since they do not make sense. However, this varies from different individuals as some could view the obsessions as being logically right. This is demonstrated for the case of Carrie. She firmly believes that her thoughts are logical and that it is normal the way she is behaving. Also, the other symptom depicted is that the affected patient could spend an enormous amount of their time on the obsessions hence interfering with their personal, social or professional activities. For example, the fact that Carrie finds herself washing hands twenty times. This is a reflection of the fact that one can find themselves spending an enormous amount of time in an activity that would otherwise be detrimental to their normal routines.

Therapeutic Treatment

The severity of the condition negates the need for the patient to access adequate treatment. The condition depicted by Carrie should be addressed through the adoption of appropriate therapeutic measures. The failure to access treatment can lead to reminiscence, and this occurs at a rate of about 20%. It is critical for the patient to have access to relevant therapeutic measures to help with the condition. The treatment for Carrie will primarily depend on her ability to function successfully. A range of therapeutic approaches exists for Carrie to enable her to overcome the challenges that arise due to the disorder.

The form of treatment is the adoption of cognitive behavioral therapy. Carrie needs to have access to cognitive behavioral therapy to help in the management of the condition. The therapy entails talking with her with a bid to help her change the manner in which she thinks (Olatunji, Davis, Powers & Smits, 2013). Further, through the conversation held with Carrie, it will be possible to transform the way she feels about germs and disease. Probably, this will help in causing her to stop behaving in the manner in which she does. For example, through the talking therapy, it would be possible to convince her to stop the behavior of washing her hands frequently. The focus is on ensuring that the patient is convinced to stop thinking the way she does so that the behaviors are altered. Further, it could be vital to engage the patient in activities that would otherwise. Finally, it could be essential to evaluate the consequences of not participating in a particular behavior. Cognitive therapy could be vital in helping the patient.

Pharmacological Treatment

A range of pharmaceutical treatments exists for the treatment of OCD. Specifically, the selective serotonin reuptake inhibitors play a crucial role in the treatment of the OCD (Chu, Chou, Lin, Cheng, Tsai, Lan, & Nestadt, 2016). It is critical to acknowledge that the form of treatment adopted depends on the cause of the condition. However, for the neurological causes, there are available drugs that can help deal with the condition. The selective serotonin reuptake inhibitors can be prescribed to the patient to help.

The different types include;

paroxetine hydrochloride

Citalopram

Escitalopram

clomipramine

The drug can be administered for at least three months. However, it is critical to indicate that not all of the patients can respond to the treatment. However, in such cases, it could be vital to use higher doses or combine the use of other forms of treatment to enhance the outcomes of the treatment.

Other forms of treatment that exist include the anti-anxiety medications since they help the patient in coping with the particular condition that they are suffering from. The choice of a given treatment depends on how best an individual responds.

Conclusion

Overall, the case analysis focused on a discussion of a medical condition, obsessive-compulsory disorder with reference to a patient, Carrie who is 12 years old. The discussion entailed an evaluation of the symptoms of the condition, the prevalence, etiology, and the additional signs to watch out in patients affected by the disease. This was concluded by a description of the available interventions necessary to address the problem. In this, both the therapeutic and pharmaceutical forms of treatment were evaluated. Overall, the insights in the discussion are essential in enhancing the understanding of the disease.

References

Arya, A., & Soodan, S. (2016). OBSESSIVE–COMPULSIVE DISORDER: PREVALENT AND DEBILITATING ILLNESS.

Bennett, S. M. (2016). Treatment of Contamination Obsessive-Compulsive Disorder. In Clinical Handbook of Obsessive-Compulsive and Related Disorders (pp. 5-21). Springer International Publishing.

Chu, C. S., Chou, P. H., Lin, C. H., Cheng, C., Tsai, C. J., Lan, T. H., ... & Nestadt, G. (2016). Use of selective serotonin reuptake inhibitors and risks of stroke in patients with obsessive compulsive disorder: a population-based study. PloS one, 11(9), e0162239.

Dell’Osso, B., Benatti, B., Altamura, A. C., & Hollander, E. (2016). Prevalence of Selective Serotonin Reuptake Inhibitor–Related Apathy in Patients With Obsessive Compulsive Disorder. Journal of Clinical Psychopharmacology, 36(6), 725-726.

http://www.medicalnewstoday.com/articles/178508.php

Jaisoorya, T. S., Reddy, Y. J., Thennarasu, K., Beena, K. V., Beena, M., & Jose, D. C. (2015). An epidemological study of obsessive compulsive disorder in adolescents from India. Comprehensive psychiatry, 61, 106-114.

Melin, K. H., Skärsäter, I., Haugland, B. S. M., & Ivarsson, T. (2015). Treatment and 12-month outcome of children and adolescents with obsessive–compulsive disorder: a naturalistic study. Journal of Obsessive-Compulsive and Related Disorders, 6, 1-6.

Niranjan, S., & Swayamprava, S. (2015). A Case study on the management of Obsessive Compulsive Disorder (OCD) in Ayurveda. International Journal of Ayurvedic Medicine, 6(3).

Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. Journal of psychiatric research, 47(1), 33-41.