Obsessive compulsive disorder

obsessive compulsive disorder with nursing intervention

1. SUSHEEL DAYALWANSI (Assistant nursing lecturer) OBSESSIVE COMPULSIVE DISORDER

2. DEFINITION Obsessive compulsive disorder is a state in which “The outstanding symptoms is a feeling of subjective compulsion– to carry out some action, to dwell on an idea, to recall an experience, or ruminate on an abstract topic. OR OCD is define as the repetitive same of experience, recall moments, behavior and activity, such as washing the hands, repetition of words.

3. ETIOLOGY Genetic factors (Monozygotic twins 35% ) Biochemical factors (Abnormal secretion of neurotransmitter serotonin ( 5-HT Hydroxytryptamine ) Psychoanalytic theory Behavior therapy- this theory explains obsession as a condition of stimulus to anxiety also called as learned theory.

4. CLINIC FEATURES OBSESSIONAL THOUGHTS:- These are words, ideas, & beliefs that intrude forcibly into the patient mind. OBSESSIONAL IMAGES:- Repeated images, scenes, and abnormal sexual practices. OBSESSIONAL RUMINATION:- ( Thoughts rumination) OBSESSIONAL DOUBTS:- Checking again and again stoves, lock, door & window. OBSESSIONAL IMPULSES:- Behave a violent & embarrassing kind such as injuring a child, shoutinng in church. OBSESSIONAL SLOWNESS:- It leads to marked slowness in daily activities.

5. OBSESSIONAL RITUALS:- Doing repetitive action or activity such as washing hand 20 times per day. (Thought of contamination) OTHERS:- Recurrent unwanted thoughts. Repetitive acts. Lack of concentration & task completion. Impaired social or work functioning. DIAGNOSTIC EVALUATION:- By demonstration of ritualistic behavior that is irrational or excessive. By M.R.I. & C.T. scan. Positron emission tomography scanning (Increase glucose metabolism in part of basal ganglia)

6. TREATMENT PHARMACOTHERAPY:- Antidepressants (Fluvoxamine, sertraline) Anxiolytics (Benzodiazepines, clonazepam) B. BEHAVIOR THERAPY:- Exposure and response prevention Thought stoppage (chair sit method , one thought, self hypnosis) Relaxation therapy Desensitization (process of reducing sensitivity) Aversive Conditioning. C. OTHER THERAPY:- Supportive psychotherapy E.C.T.- for patient refractory to other forms of treatment.

7. NURSING MANAGENT ASSESSMENT:- Collect the physical , psychological & social data. Assess patient repetitive ideas & action. Assess the patient obsession & compulsive physical functioning. NURSING DIAGNOSIS:- Ineffective individual coping related to under developed ego, punitive superego, avoidance learning, possible biochemical changes, evidenced by ritualistic behavior or obsessive thoughts. Altered role performing related to the need to perform rituals, evidenced by inability to fulfill usual patterns of responsibility.

8. NURSING INTERVENTION Work with patient to determine types of situation that increase anxiety and result in ritualistic behavior. Support patient’s efforts to explore the meaning and purpose of the behavior. Provide structured schedule of activities for patient, include adequate time for completion of rituals. Give positive reinforcement for non ritualistic behavior. Encourage patient to discuss conflicts.

9. THANK YOU