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CASE
PROFILE
ON OCD
By- chaitra XIE
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Introduction
Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition
characterized by persistent, unwanted thoughts (obsessions) and repetitive
behaviours (compulsions). These obsessions and compulsions can significantly
interfere with daily life and cause substantial distress.
Nature of the Problem
OCD manifests in two primary forms: obsessions and compulsions.
Obsessions are intrusive and recurring thoughts, images, or urges that cause intense
anxiety. Common obsessions include fears of contamination, harming oneself or
others, and unwanted sexual or religious thoughts.
Compulsions are repetitive behaviours or mental acts performed to alleviate the
anxiety caused by obsessions. These can include excessive cleaning, checking,
counting, or repeating actions.
Incidence
OCD affects approximately 1-2% of the global population, with onset typically
occurring in late adolescence or early adulthood. However, it can begin in childhood.
The disorder affects men and women equally, although men often develop symptoms
at a younger age.
Aetiology
The exact cause of OCD is not fully understood, but research suggests some factors.
Key factors include:
Genetics: Family studies indicate that individuals with a first-degree relative with
OCD are at higher risk of developing the disorder.
Neurological Factors: Abnormalities in brain structure and function and
neurotransmitter imbalances, are also implicated.
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Behavioural and Cognitive Factors: Learned behaviours and maladaptive thought
patterns can contribute to the development and maintenance of OCD. Individuals may
develop compulsions as a way to reduce the distress caused by obsessions.
Environmental Stressors: Traumatic events, chronic stress, and significant life
changes can trigger the onset of OCD in predisposed individuals.
Evidence-Based Treatments for OCD
Cognitive-Behavioral Therapy (CBT): Specifically, Exposure and Response
Prevention (ERP) is considered the gold standard treatment for OCD. ERP involves
gradual exposure to feared situations and prevention of the compulsive response,
helping reduce anxiety over time.
Combination Therapy: Research has shown that a combination of CBT and SSRIs
can be more effective for some individuals than either treatment alone.
Mindfulness-Based Therapies: These therapies can help individuals manage their
symptoms by increasing awareness and acceptance of their thoughts and feelings
without engaging in compulsive behaviours.
Medication: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed
to help manage symptoms. In some cases, other medications such as tricyclic
antidepressants (e.g., clomipramine) or antipsychotics may be used.
Alternative Therapies: Mindfulness-based approaches, Acceptance and Commitment
Therapy (ACT), and family therapy can also be beneficial, particularly in addressing
the broader impact of OCD on an individual's life.
Diagnostic criteria for ocd dsm 5
1. Recurrent, persistent, and unwanted thoughts, urges, or images (obsessions) that
are intrusive and cause distress, and
2. Repetitive behaviours or mental acts (compulsions) aimed at preventing or
reducing distress or preventing some dreaded event or situation.
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Brief summary of the case
Sanjay, a 16-year-old boy, has been receiving professional help to manage his OCD
symptoms. He first began experiencing symptoms at the age of 13, which included intrusive
thoughts and compulsive behaviours like excessive handwashing and organising. Early
intervention is key for adolescents with OCD, as it helps them gain control over their
symptoms and develop healthier coping mechanisms. For the past six months, Sanjay has
been seeing a school counsellor, and more recently, he has started working with a specialist
to address his condition more intensively.
Sanjay’s positive attitude towards counselling, along with the specialised cognitive-behavioural therapy
(CBT) he is receiving, offers hope for effectively managing his OCD. The therapy includes techniques
like exposure and response prevention (ERP), which help him gradually confront and reduce his
compulsions. In addition to therapy, family support plays a crucial role in his progress, and with
continued dedication, Sanjay has a promising path toward managing his OCD symptoms.
Identification of data
Name - Sanjay Reddy
Diagnosed - Obsessive-compulsive
disorder
Referral - By his school counsellor
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Case history
Sanjay is a 16-year-old boy currently in the 11th grade at St Peter's
High School. As an average student academically, Sanjay
compensates with active participation in extracurricular activities,
notably the school’s chess club. His involvement in these activities
demonstrates his ability to engage with peers and manage
responsibilities outside of the academic sphere.
Socio-Economic Status (SES):
Sanjay hails from a middle-class family. His father, Anil, is a
mechanical engineer with a bachelor's degree in engineering, and his
mother, Navya, is a high school teacher holding a master's degree in
education. The family's combined annual income is approximately
12.5 lakhs, and they reside in a three-bedroom apartment. This stable
and supportive home environment is indicative of a well-educated
family valuing academic and professional achievement.
Physical Health:
Sanjay is physically healthy, standing at 6'3" and weighing 82 kg. He
has no history of significant illnesses or disabilities. His physical
characteristics are typical for his age, and he participates in regular
physical activities, such as jogging and swimming.
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Signs and Symptoms:
Around the age of 13, Sanjay began exhibiting symptoms of
Obsessive-Compulsive Disorder (OCD). He experiences intrusive
thoughts primarily related to contamination and harm, which lead to
compulsive behaviours. His rituals include excessive handwashing
and meticulous organising. Observations highlight Sanjay’s anxious
facial expressions, frequent fidgeting, and avoidance of situations that
trigger his compulsions. He reports persistent fears of contamination
and harm, excessive worry about making mistakes, and a high level
of tension that disrupts his sleep patterns. These symptoms indicate a
significant impact on his daily functioning and well-being.
Professional Help Taken:
Recognizing the need for professional intervention, Sanjay has been
seeing a school counsellor for the past six months. The counsellor's
support has provided some relief and coping strategies, but Sanjay’s
symptoms persist. Recently, he began sessions with a licensed
therapist specializing in OCD and anxiety disorders. Sanjay's general
attitude towards counselling and therapy is positive, suggesting an
openness to treatment and a willingness to work on managing his
symptoms. This proactive approach, coupled with professional
guidance, is crucial for addressing his OCD effectively.
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Concluding comments
Sanjay’s case highlights the complex and challenging nature of
Obsessive-Compulsive Disorder (OCD), particularly in adolescence.
Despite a supportive family background, stable socio-economic status,
and good physical health, his intrusive thoughts and compulsive
behaviours significantly impact his daily life and mental well-being.
Continued therapy and consistent support from both family and school are
essential for Sanjay’s progress. With ongoing professional help, Sanjay
has the potential to develop effective coping mechanisms and improve his
quality of life.
Obsessive-Compulsive Disorder is a chronic mental health condition
characterized by persistent, unwanted thoughts (obsessions) and
repetitive behaviours (compulsions) that an individual feels driven to
perform. It often emerges in childhood or adolescence and can persist into
adulthood if not properly managed.
Early diagnosis and intervention are crucial for better outcomes. Support
from family, friends, and educational institutions plays a vital role in the
management and recovery process. Understanding and awareness of
OCD are essential in reducing stigma and ensuring those affected receive
the support and treatment they need. With appropriate treatment,
individuals with OCD can lead fulfilling lives and manage their symptoms
effectively.
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Family tree
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References
- NCERT class 12 Psychology textbook
- National Institute of Mental Health ( https://www.nimh.nih.gov/ )
- https://www.mayoclinic.org/
- https://www.mcleanhospital.org/essential/ocd
