Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example

Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example

Obsessive-compulsive Disorder (OCD) is a highly prevalent and chronic neuropsychiatric condition marked by reoccurring, uncontrollable thoughts (obsessions) and or behaviors (compulsions) that render patients to feel the urge to repeat them over and over again. While obsessions entail unwanted, intrusive thoughts, impulses, or images that increase anxiety, compulsions are repetitive mental acts or behaviors that lead to decreased anxiety (Stein et al., 2019). The condition presents with varied symptoms that challenge diagnosis and treatment. Children and adolescents are highly affected since they have difficulty identifying and describing obsessions and compulsions compared to adults. However, rigorous research on psychobiology, phenomenology, pharmacology, and psychotherapy has improved recognition, assessment, and outcome. Of importance, patient education supports treatment compliance leading to improved outcomes.(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)

Signs and Symptoms

The symptoms include a ‘contamination’ dimension characterized by cleanliness and contamination obsessions and showering, cleaning, and washing compulsions, a ‘harmful thoughts’ dimension portrayed by an obsession about harm to self and others and checking compulsions, and an ‘unacceptability’ dimension marked by aggressive, religious and sexual obsessions and mental rituals or praying compulsions (Stein et al., 2019). Other symptoms entail a ‘symmetry’ dimension characterized by ordering, repeating, straightening, or counting compulsions and a ‘hoarding’ dimension marked by saving or hoarding symptoms and hoarding behaviors compulsions such as persistent difficulty to part with one possession.(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)

Pharmacological and Non-Pharmacological Treatments

While treatment of OCD may not result in to cure, it helps to manage the symptoms. The treatment may also be intensive and long-term, depending on the severity. For pharmacological treatment, a tricyclic antidepressant, Clomipramine, is an FDA –approved medication for OCD. The initial dose should be 25 mg orally once a day in bed, while it can be gradually increased to 100mg per day to a maximum dosage of 200 mg per day for 10-17 year aged patients (Paxos, 2022). Antidepressants are highly linked to suicidal thoughts and behavior; thus, the risks should balance clinical needs coupled with close observation and communication with the patient. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (80mg, 7-17 years), sertraline (6-17 years), and Fluvoxamine (300 mg, 8-17 years) are effective for OCD patients when used in high doses. OCD symptoms take longer to respond to SSRIs and require an 8-12 weeks program to be effective (Stein et al., 2019).(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)

One of the evidence-based psychotherapy treatments for OCD is cognitive behavioral therapy, especially exposure with response prevention (ERP). Group and individual CBT with ERP efficacy have been proven as it records about 45% to 70% treatment response change (Hamatani et al., 2020). The treatment entails psycho-education about the condition and the ERP process. The patients also fill out a 24-hour obsession and compulsion symptom log to collect data to construct the symptoms’ hierarchy. A patient with contamination symptoms may consider touching a public toilet seat more provoking than a public doorknob. Thus, the patient is encouraged to work on such exposures moving up their symptom hierarchy. Subsequently, Transcranial Magnetic Stimulation (TMS) is highly effective for children and adolescents with OCD. The treatment is advantageous as it reduces or stops medications use, it is non-invasive, non-sedative, and has minimal medication side effects (Yu et al., 2022).(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)

Community Resource and Referrals

Community resources and referrals are required for children and adolescents with OCD. First, there is a need to integrate and expand the use of technology such as Transcranial Magnetic Stimulation (TMS) in treating OCD. Secondly, education efforts should focus on training new mental health practitioners while improving the education of current clinicians, such as psychiatrists, counselors, psychologists, and social workers (Cook et al., 2019). As such, patients can be referred to different mental health practitioners who address their diverse needs. Providing financial resources is instrumental in catering to costly therapy and medications. Nonetheless, advocacy, coping, and support from the members of the public will elicit improved outcomes. Collaboration between mental health organizations such as the American Psychiatry Association, American Psychological Association, National Alliance of Mental Illness, and the National Institute of Mental Health also support policy changes and managing and diagnosing psychiatric conditions among children and adolescents.(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)

References

Cook, J. M., Newman, E., & Simiola, V. (2019). Trauma training: Competencies, initiatives, and resources. Psychotherapy, 56(3), 409.(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example) http://dx.doi.org/10.1037/pst0000233

Hamatani, S., Tsuchiyagaito, A., Nihei, M., Hayashi, Y., Yoshida, T., Takahashi, J., … & Hirano, Y. (2020). Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry, 20, 1-8(Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example). https://link.springer.com/article/10.1186/s12888-020-02841-4

Paxos, C. (2022). Moving beyond first-line treatment options for OCD. Mental Health Clinician, 12(5), 300-308. http://meridian.allenpress.com/mhc/article-pdf/12/5/300/3139012/i2168-9709-12-5-300.pdf

Stein, D. J., Costa, D. L., Lochner, C., Miguel, E. C., Reddy, Y. J., Shavitt, R. G., … & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature Reviews Disease Primers, 5(1), 52. (Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370844/

Yu, L., Li, Y., Yan, J., Wen, F., Wang, F., Liu, J., … & Li, Y. (2022). Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder and Tic Disorder: A Quick Review. Journal of Integrative Neuroscience, 21(6), 172. (Obsessive Compulsive Disorder in Children and Adolescents Comprehensive Nursing Essay Example)https://www.imrpress.com/journal/JIN/21/6/10.31083/j.jin2106172/htm