scholarly journals Psychotropic medication, psychiatric disorders, and higher brain functions

2000 ◽  
Vol 2 (3) ◽  
pp. 177-182
Keyword(s):  
Psychotropic Medication ◽  
Psychiatric Symptoms ◽  
Brain Dysfunction ◽  
Obsessive Compulsive ◽  
Clinical Neuroscience ◽  
Compulsive Disorder ◽  
Brain Functions ◽  
Higher Brain Functions ◽  
Level Of Analysis

Conventional psychiatric diagnosis is founded on symptom description; this then governs the choice of psychotropic medication. This purely descriptive approach resembles a description of diphtheria from the premicrobiology era. Based on current advances in basic and clinical neuroscience, we propose inserting an intermediate level of analysis between psychiatric symptoms and pharmacologic modes of action. Paradigm 1 is to analyze psychiatric symptoms in terms of which higher brain function(s) is (are) abnormal, ie, symptoms should be analyzed as higher brain dysfunction: a case study in obsessive-compulsive disorder reveals pointers in four common symptoms to the higher functions of working memory, emotional overlay, absence of voluntary control, and the ability to evaluate personal mental phenomena. Paradigm 2 is to view psychotropic drugs as modifying normal higher brain functions, rather than merely treating symptoms, which they do only secondarily: thus depression may respond to agents that act on related aspects of mental life derived from higher brain functions, eg, the ability to enhance bonding. We advocate a strategy in which psychiatric illness is progressively reclassified through knowledge in clinical neuroscience and treatment targets are revised accordingly.

The Life-World of the Obsessive-Compulsive Person

2018 ◽  
pp. 633-648
Author(s):  
Martin Bürgy
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Psychiatric Symptoms ◽  
Phenomenological Method ◽  
Symptom Development ◽  
Obsessive Compulsive ◽  
Life World ◽  
Compulsive Disorder ◽  
The World ◽  
And Coping

Taking up the work of Karl Jaspers, we develop a phenomenological method, which has not been fully used in clinical practice. We describe three levels of understanding of psychiatric symptoms: the static understanding as a description of symptoms in the here and now; the genetic understanding of symptom development; and the hermeneutic understanding as an interpretation of meaning and sense. This phenomenological method is illustrated using its application in obsessive-compulsive disorder. Previous findings are thus organized and illustrated on the basis of a case study. This leads us to a deeper understanding of obsessive-compulsive disorder, both from the disturbance side, as well as from the defending and coping side, to a deeper understanding, too, of its development and of the world- and self-experiencing.

scholarly journals Acceptance and Commitment Therapy in Obsessive–Compulsive Disorder: A Case Study

2021 ◽  
pp. 025371762199673
Author(s):  
Joel Philip ◽  
Vinu Cherian
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Third Wave ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Change Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Recent years have witnessed an increased interest in the use of “third-wave” psychotherapies in treating psychiatric disorders. These newer therapies are fundamentally different from the existing techniques such as cognitive behavioral therapy in terms of their guiding principles and processes of change. Acceptance and commitment therapy (ACT) is the most prominent among these “third wave” psychotherapies. However, there have not been any reports from India, thus far, that have studied the use of ACT in treating obsessive–compulsive disorder (OCD). We describe a case of OCD that was successfully treated with eight sessions of ACT, with the results being maintained over a one-month follow-up period. Postintervention tests revealed a significant decrease in obsessive–compulsive symptoms and an associated increase in psychological flexibility. This case study highlights the possible utility of ACT as a therapeutic intervention in OCD, especially when combined with pharmacotherapy.

scholarly journals Schizophrenia with Obsessive Compulsive Symptoms: A Case Report

2019 ◽  
Vol 8 (1) ◽  
pp. 66-67
Author(s):  
A Jha ◽  
D Joshi
Keyword(s):  
Case Report ◽  
Obsessive Compulsive Disorder ◽  
Poor Response ◽  
Clinical Impact ◽  
Anti Psychotic ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Co Morbidity

Obsessive-compulsive disorder/ symptoms may be co-morbid in schizophrenia. The clinical impact of this co-morbidity is poor response to anti-psychotic medications. We present a case of 35 yr old female who presented with symptoms suggestive of schizophrenia and later co-morbid obsessive symptom responded well to addition of fluoxetine to antipsychotics. This case study reveals that the identification and treatment of OCD in schizophrenia is very crucial for optimistic outcome.

ASD, OCD and violence – a forensic case study

2020 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
Holly Edwards ◽  
Lorraine Higham
Keyword(s):  
Emotional Regulation ◽  
Aggressive Behaviour ◽  
Psychological Treatment ◽  
Autism Spectrum ◽  
Complex Case ◽  
Obsessive Compulsive ◽  
Content Type ◽  
Compulsive Disorder ◽  
Offending Behaviour

Purpose The purpose of this paper is to illustrate the formulation and psychological treatment of a complex case whereby a combination of autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) has resulted in violent and aggressive behaviour. Design/methodology/approach This paper provides a brief summary of literature in relation to ASD, OCD and risk-offending behaviour followed by a case study of a man (referred to as “John”) with a diagnosis of ASD and OCD who has an extensive history of institutional violence and aggressive behaviour. Findings This paper highlights the complexity of a case that may support research suggesting that impaired theory of mind, poor emotional regulation and problems with moral reasoning increase the risk of an individual with ASD engaging in violence, in addition to a comorbidity of ASD and OCD resulting in a more severe and treatment-resistant form of OCD. Originality/value This paper highlights the challenges faced when working with a patient with Asperger’s syndrome and OCD with entrenched beliefs that lead to the use of violence as a compulsion to temporarily overcome unpleasant thoughts related to low self-esteem.

Who Am I? A Life Story Intervention for Persons With Intellectual Disability and Psychiatric Problems

2016 ◽  
Vol 54 (3) ◽  
pp. 173-186 ◽  
Author(s):  
Gerben J. Westerhof ◽  
Janny Beernink ◽  
Anneke Sools
Keyword(s):  
Intellectual Disability ◽  
Life Story ◽  
Psychiatric Symptoms ◽  
Qualitative Evaluation ◽  
Obsessive Compulsive ◽  
Personal Learning ◽  
Compulsive Disorder ◽  
Life Review Therapy ◽  
Psychiatric Problems

Abstract This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative evaluation of the intervention was carried out with 25 participants. Results showed large changes in psychiatric symptoms, in particular on depression, anxiety, obsessive-compulsive disorder, and interpersonal sensitivity. Participants were mainly positive in their general explicit evaluations of the therapy as well as on personal learning points, intervention-specific, group-related, and therapist-related aspects. It is concluded that the intervention is promising for the treatment of people with ID and psychiatric complaints.

Exposure and Response Prevention for Obsessive-Compulsive Disorder: A Case Study of a Veteran With Violent Intrusive Thoughts

2019 ◽  
Vol 33 (1) ◽  
pp. 71-81
Author(s):  
Veronica Siffert ◽  
Colette Riahi ◽  
Melinda A. Stanley ◽  
Terri L. Fletcher
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Negative Emotion ◽  
Response Prevention ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Supportive Psychotherapy ◽  
Compulsive Disorder ◽  
Patient Health ◽  
Poor Treatment

Exposure and Response Prevention (ERP) is the gold standard treatment for obsessive-compulsive disorder (OCD); however, few studies have evaluated the use of ERP with veterans. This case study describes ERP and medication treatment of a veteran who experienced violent sexual thoughts, countered by compulsions of focusing on the distressing thought to ensure a negative emotion or reversing the thought to a nonviolent thought or image. The veteran had previously received supportive psychotherapy and medication for depression, anxiety, and sleep difficulties, with poor treatment adherence. Upon reengagement in treatment, the therapist provided ERP in 34 sessions over 14 months, with 15 sessions via video telehealth to home. The patient used the OCD Workbook as a resource throughout treatment. The patient developed a hierarchy of target obsessions and rituals with associated subjective units of distress; completed exposures, beginning with lower-level items; and wrote imaginal scripts. He also received zolpidem for insomnia and venlafaxine for anxiety and depression. His scores on the nine-item Patient Health Questionnaire and Yale Brown Obsessive-Compulsive Scale decreased significantly.

EMDR in the Treatment of Adolescent Obsessive-Compulsive Disorder: A Case Study

2018 ◽  
Vol 12 (4) ◽  
pp. 242-254
Author(s):  
Angela Cusimano
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Current Level ◽  
Practice Setting ◽  
Large Effect Size ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Insight Into

Most of the empirical evidence supporting the efficacy of eye movement desensitization and reprocessing (EMDR) has been with individuals suffering from posttraumatic stress disorder (PTSD). This case study reports on the successful treatment of obsessive-compulsive disorder (OCD) in a 13-year-old male using the standard three-pronged approach of EMDR in a private practice setting. The current protocol addressed the initial touchstone event, the current level of distress related to that event, as well as anticipation and planning for future feared events. The participant received 15 sessions of EMDR. At 90-day posttreatment follow-up, there was a substantial decrease in OCD symptoms (from moderate to subclinical) as measured by the Children’s Yale-Brown Obsessive–Compulsive Scale, indicating a large effect size (d = 0.81). The current study provides insight into treating OCD in adolescence and how using the three-pronged approach (past, present, and future) of EMDR can be an effective tool. Study limitations and suggestions for future clinical research are discussed.

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