wk4 Respond to Prac
Dele
wk4Respondto4peoplePrac.docxRespond to 4 people.Include 2 citations and 2 references for each response
1.Respond to Kadjatu, include 2 citations and 2 references.
,RE: Discussion - Week 4 reply 1
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Thank you colleague for your post on OCD,
I would like to offer a reply to your first question: how is OCD related to panic disorder, GAD, and severe phobia?
As with many mental health disorders, OCD shares common features with other psychiatric disorders. Those patients with OCD and anxiety disorders have an underlying common stressor or anxiety that may be real or perceived as real. The difference is the way the stressors present and the rituals of lack of that distinguish between these disorders. Goodwin (2015) stated the following: To demonstrate that there is an overlap between depression, anxiety disorder, and OCD that is likely to rest on shared brain mechanisms, it will be important to consider the evidence for shared genes shared brain mechanisms and shared treatment effects According to the DSM-5, Recurrent thoughts, avoidant behaviors, and repetitive requests for reassurance can also occur in anxiety disorders. However, the recurrent thoughts that are present in GAD are usually about real-life concerns, whereas the obsessions of OCD usually do not involve real-life concerns and can include content that is odd, irrational, or of a seemingly magical nature. (Apa,2013). It is also important to mention that to properly diagnose and create a treatment plan, the PMHNP must recognize these subtle differences. Falk, Goldman, Mohatt (2020)noted that taking into consideration the source of the threat, the nature of the thoughts, and any reported compulsive behaviors will help in the differential diagnosis. For example, the source of threat can help distinguish between the various anxiety disorders. According to DSM, the presence or absence of “non-real-life concerns” or content that is “odd, irrational, or of a seemingly magical nature” can often indicate OCD.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Falk A, Goldman R, Mohatt,J (2020).Is It OCD or an Anxiety Disorder? Considerations for Differential Diagnosis and Treatment. (2020). Retrieved June 23, 2021, from https://www.psychiatrictimes.com/view/it-ocd-or-anxiety-disorder-considerations-differential-diagnosis-and-treatment
GooGGoodwin.GM (2015). The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in clinical neuroscience, 17(3), 249–260. https://doi.org/10.31887/DCNS.2015.17.3/ggoodwin
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1. Respond to Christina Vasquez , include 2 citations and 2 referenes.
RE: Discussion - Week 4
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Thank you very much for your post! I would like to tackle your question about what would I do differentlyy and why and also discuss about how similar OCD is to panic disorder and anxiety type disorders. According to the DSM 5 patients with OCD are forced to perform repetitive behaviors in response to an obsession (American Psychiatric Association, 2013). These repetitive behaviors are called compulsions and can help to relieve the anxiety that the patientt is feeling. The obsessions are recurrent unwanted thoughts, images or urges. In generalized anxiety that worry is excessive and must occur for more than 6 months and must cause a significant impairment on at least one area of the patients life (American Psychiatric Association, 2013). I believe that both of these disorders can lead to a panic attack or a panic disorder. Panic attacks are intense feelings of fear and or intense worry and can be accompanied by physical symptoms such as, diaphoresis, tachycardia, chest pain and feelings of impending doom (American Psychiatric Association, 2013) .
OCD can be very challenging to treat and their aren't many pharmacological treatments that are FDA approved for the treatment of OCD. I do agree that Fluoxetine is a good option and it is FDA approved for the treatment of OCD for patients over the age of 7. I believe the best treatment option for OCD would include a pharmacological component as well as psychotherapy component. I agree that increasing the Fluoxetine would be a good next step for her but I would also add CBT to her treatment plan. Specifically Exposure and response prevention CBT. This type of therapy is usually between 12- 24 sessions long and includes a series of planned exposures with the therapist and also for the client to perform at home (Lack, 2012). Since ERP was recognized as a treatment option for OCD it has been noted as a viable treatment option for those suffering with OCD. (Hezel & Simpson,2019).
Another option that has show efficacy in the treatment of OCD is computer assisted CBT. In a study done all participants showed a reduction in symptoms utilizing the Yale-Brown Obsessive Compulsive Scale. This on line self help model is becoming more popular and has shown significant efficacy ( Kobak, et al., 2015).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian journal of psychiatry, 61(Suppl 1), S85–S92. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_516_18
Kobak, K. A., Greist, R., Jacobi, D. M., Levy-Mack, H., & Greist, J. H. (2015). Computer-assisted cognitive behavior therapy for obsessive-compulsive disorder: a randomized trial on the impact of lay vs. professional coaching. Annals of general psychiatry, 14, 10. https://doi.org/10.1186/s12991-015-0048-0
Lack C. W. (2012). Obsessive-compulsive disorder: Evidence-based treatments and future directions for research. World journal of psychiatry, 2(6), 86–90. https://doi.org/10.5498/wjp.v2.i6.86
2. Respond to 2 hours ago
Wanda Sal , include 2 citations and 2 references.
RE: Discussion - Week 4
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Hello ,
I really enjoyed your informative presentation. I would like to answer the question of why is ethics crucial to each diagnosis and
treatment. Providers are in a dilemma when it comes to medical ethics of a patient. Providers have to use experience, logic and a patient
values in beliefs to determine the treatment that is best. I know that you stated that the patient was a Hispanic female. In Hispanic cultures,
they fear the fact of seeking mental health treatment due to being called crazy (National Alliance on Mental Illness, n.d.). Another problem with
the Hispanic population is they might not seek treatment due to no insurance or may not return for a follow-up appointment. Cultural
differences may lead mental providers to misunderstand and misdiagnose the Hispanic cultural (Office of Minority Health, n.d.). I realized that
you stated that your treatment plan was that the patient would get labs completed and a follow-up appointment in three weeks. It is important
that the case management get involve to find out the living situation for these patients and if they need some type of assistance before
discharge.
References
Hispanic/Latinx. NAMI. (n.d.). https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Hispanic-Latinx.
Office of Minority Health. Mental and Behavioral Health - Hispanics - The Office of Minority Health. (n.d.).
https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=69.
Understanding Culture: Mental Illness in the Hispanic Community. Legacy Community Health. (2019, August 7).
https://www.legacycommunityhealth.org/understanding-culture-mental-illness-in-the-hispanic-community/.
1 hour ago
4. Priscillia Omoleme include 2 citations and 2 references.
RE: Discussion - Week 4
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Hello,
Thank you for your comprehensive presentation. Patient E demonstrates symptoms of OCD and anxiety. In your objective data, I think it would be more crucial to include thyroid hormone profile and complete blood count to rule out any medical causes of the patient’s symptoms. Mermi & Atmaca (2016) wrote that altered thyroid hormone levels are associated with the pathophysiology and maintenance of obsessive-compulsive symptoms. Also, does E have an insight into his mental disturbance? A patient’s insight into their illness informs the approach the practitioner will employ. What disqualifies the patient from meeting DSM 5 criteria for an anxiety disorder? According to DSM 5 diagnosis criteria for OCD, a person should exhibit repetitive behaviors such as hand-washing or checking the door or mental acts such as praying or counting. These acts are often aimed at reducing distress or preventing dreadful events and consume considerable time (more than one hour in a day), thus significant social, occupational, and academic impairments (APA, 2013). In your presentation, E does not exhibit any compulsive behavior.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Mermi, O., & Atmaca, M. (2016). Thyroid gland functions are affected in obsessive-compulsive disorder. Anatolian Journal of Psychiatry, 17(2), 99-103.
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