Posted: October 6th, 2022

Captain of the Ship Project – Obsessive-Compulsive Disorders

Week 7: Captain of the Ship Project – Obsessive-Compulsive Disorders

Pupil Identify
School of Nursing-PMHNP, Walden College
NRNP 6670: Psychiatric Psychological Well being Nurse Practitioner Function II: Adults and Older Adults

Week 7: Captain of the Ship Project – Obsessive-Compulsive Disorders
Introduction
Obsessive-compulsive dysfunction presents itself in numerous methods. Sufferers with obsessive-compulsive persona dysfunction expertise difficulties relating with different individuals. Healthcare staff have a accountability to look at sufferers and diagnose sufferers. The most effective treatment for the affected person is sertraline, similar to Zoloft 50mg PO day by day. The affected person requires particular person psychotherapy to complement the treatment. Cognitive conduct remedy is the greatest therapy for sufferers with OCPD. Housing is a crucial group useful resource to reinforce restoration and stop relapse. A follow-up is critical for the affected person to fast-track their therapy and restoration. The ship mission captain on obsessive-compulsive persona dysfunction entails medical impression, therapy, medical administration wants, group assets, and follow-up.
HPI and Medical Impression
The affected person I met in the practicum was a 36-year-old girl who had marital difficulties because of her perfectionist conduct. She believes the husband is just not excellent sufficient. She complained of issue expressing emotions and feeling excellent. She desires to impose her requirements on her husband, who objects to her way of life. The affected person complained of social isolation, feeling offended, and nervousness. The lady has been taking antidepressants however with out persistently adhering to the dose. She divorced from her first husband, who remained along with her youngsters. She is married to a different husband, however feeling her perfectionist spirit could result in separation. Her mother and father dwell in one other state whereas the husband is jobless. The couple has a historical past of melancholy and hypertension. She is taking treatment to stabilize the hypertension.
Psychopharmacologic Remedies and Therapeutic Endpoints
The most effective treatment for the affected person is sertraline, similar to Zoloft 50mg PO day by day. Sertraline is a sort of selective serotonin reuptake inhibitor that will increase the serotonin hormone’s chemical exercise in the mind (Palm et al., 2017). Zoloft is the greatest first line of therapy for sufferers with obsessive-compulsive problems. The drug is efficient because it has fewer negative effects and excessive effectivity (Cain & Mounsey, 2020). The affected person ought to take the drug for 4 weeks and are available again for additional analysis. Adherence to the therapy is to maintain the price of restoration.
The therapeutic endpoints embody a discount in the severity of the signs. For instance, it’s anticipated after the first 4 weeks, the affected person ought to expertise few episodes of anger, nervousness, and social isolation (Cain & Mounsey, 2020). The affected person ought to report fewer episodes of emphasizing perfection on her husband. One other therapeutic endpoint is adherence to the Zoloft drug with few negative effects (Cain & Mounsey, 2020). The drug ought to Help the affected person relate comfortably with the husband and attend to her work duties with out social isolation and nervousness.
Psychotherapy Selections and Therapeutic Endpoints
The affected person requires particular person psychotherapy to complement the treatment. Cognitive conduct remedy is the greatest therapy for sufferers with OCPD (Key et al., 2017). CBT successfully teaches the sufferers to acknowledge their pondering errors and why the conduct is maladaptive. Psychotherapy is important in studying the methods of dwelling with out dropping management, incapability to finish duties, and perfectionism (Key et al., 2017). Therapy is important to Help people to dwell with different individuals regardless of their conduct. People have a accountability to attend not less than ten periods each week. I’ll refer the shopper to a counselor for the psychotherapeutic periods. The therapeutic endpoint is to vary the shopper’s pondering patterns and eradicate undesirable ideas (Key et al., 2017). Altering the pondering patterns will improve the affected person’s high quality of life and permit the affected person to expertise a greater relationship with the husband. The remedy ought to Help the affected person keep away from anxious and offended emotions that undermine her high quality of life.
Household psychotherapy is important since her associate might require counseling to Help her to dwell with the shopper. The remedy is important to keep away from the danger of divorce and marital stress (Key et al., 2017). The affected person ought to go to the remedy alone for Eight-10 periods and attend different periods with the associate.
Medical Administration Wants
The primary line of therapy for the situation is a selective serotonin reuptake inhibitor. Zoloft is the greatest treatment for the affected person. Zoloft 50mg is an applicable dose since a decrease dose wouldn’t be efficient, whereas the next dose would set off hostile reactions (Fineberg et al., 2018). It will likely be important to look at the affected person after 4 weeks to determine medical wants. Throughout the second go to to the clinic, an increment to Zoloft 75mg will probably be obligatory to reinforce therapy effectivity. Growing the dose to 100mg will probably be dangerous for the affected person (Fineberg et al., 2018). Altering the drug would current a danger of hostile reactions. A affirmation about allergic reactions is critical earlier than the prescription of the drug. The affected person ought to proceed with the present medicines to foster restoration.
Group Help Assets
The affected person requires group help since her husband is jobless. She misplaced her job after the divorce from her ex-husband. She requires housing since she is sort of dealing with an eviction from her present home. One other Help she requires is meals since she is just not at the moment incomes a wage. Connections to employers will probably be obligatory. The affected person requires connection to help teams of different individuals with obsessive-compulsive dysfunction. Help peer teams will Help her recuperate when she learns of restoration’s testimonies (Thamby & Khanna, 2019).
Observe-Up Depth and Frequency and Collaboration
The follow-up is important for psychological healthcare sufferers. The affected person would require follow-up after each 4 weeks. The follow-up will probably be important for figuring out the therapy selections. It’s anticipated that after 12 weeks, the affected person will expertise vital restoration (Thamby & Khanna, 2019). The follow-up will probably be important if the develop develops issues earlier than the finish of each 4 weeks.
The collaboration will probably be important to reinforce the efficacy of therapy. A collaboration with a counselor will probably be important for psychotherapy. A counselor will Help the affected person change the pondering patterns about perfection and Help her dwell with different individuals (Thamby & Khanna, 2019). The affected person could require a psychological standing examination if she doesn’t enhance after 4 to eight weeks of therapy.
Conclusion
The case examine entails a 36-year-old girl who had marital difficulties because of her perfectionist conduct. Zoloft is the greatest first line of therapy for sufferers with obsessive-compulsive problems. Cognitive conduct remedy is the greatest therapy for sufferers with OCPD. CBT successfully teaches the sufferers to acknowledge their pondering errors and why the conduct is maladaptive. The affected person requires group assets similar to housing and peer help teams. The affected person would require follow-up after each 4 weeks to find out the restoration, danger of relapse, and analysis of therapy selections. The therapy is efficient to forestall relapse and enhance the high quality of life of a person.

References
Cain, N. M., & Mounsey, T. P. (2020). Obsessive‐Compulsive Persona Dysfunction. The Wiley Encyclopedia of Persona and Particular person Variations: Medical, Utilized, and Cross‐Cultural Analysis, 103-107.
Fineberg, N. A., Apergis-Schoute, A. M., Vaghi, M. M., Banca, P., Gillan, C. M., Voon, V., … & Robbins, T. W. (2018). Mapping compulsivity in the DSM-5 obsessive compulsive and associated problems: cognitive domains, neural circuitry, and therapy. Worldwide Journal of Neuropsychopharmacology, 21(1), 42-58.
Key, B. L., Rowa, Ok., Bieling, P., McCabe, R., & Pawluk, E. J. (2017). Mindfulness‐based mostly cognitive remedy as an augmentation therapy for obsessive–compulsive dysfunction. Medical Psychology & Psychotherapy, 24(5), 1109-1120.
Palm, U., Leitner, B., Kirsch, B., Behler, N., Kumpf, U., Wulf, L., … & Hasan, A. (2017). Prefrontal tDCS and sertraline in obsessive compulsive dysfunction: a case report and assessment of the literature. Neurocase, 23(2), 173-177.
Thamby, A., & Khanna, S. (2019). The function of persona problems in obsessive-compulsive dysfunction. Indian journal of psychiatry, 61(Suppl 1), S114.

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Tags: Captain of the Ship Project – Obsessive-Compulsive Disorders, NRNP 6670