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1 day ago
Week -6-: Obsessive Compulsive Disorder vs Adjustment Disorder
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Obsessive Compulsive Disorder vs Adjustment Disorder
OCD is chgracterized by the presence of obsesioins and/or compulsions. In OCD, obsessions are recurring thoughts that may cause anxiety, while compulsions are repeated actions or mental activities that are done in response to an addiction or according to laws that must be followed(Seibell,2014).
Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressors occurring within 3 months of the onset of the stressor causing significant impairment in social, occupational, or other important ares of functioning(Patra, 2013).
Difference between an adjustment disorder
OCD differs from adjustment disorder in that the obsessive behaviors cause distress and compulsive behaviors are acts performed in an attempt to decrease their anxiety(Seibell,2014). OCD creates a vicious loop in which OCD worsens every time a compulsive activity or a mental act is performed, leading to an intensification of obsessions and compulsion(Ex.skin picking, Trichotillomania,fear of contamination-excessive hand washing).
In patients with adjustment disorders, the stress-response is situational leading to difficulties adjusting after a stressful event at a level disproportionate to the severity or intensity of the stressor(Patra, 2013). These symptoms are characterised by stress responses that are out of step with socially or culturally expected reactions to the stressor and/or which cause marked distress and impairment in daily functioning(Patra, 2013).Good examples are subjective distress and emotional disturbance, such as significant life changes, stressful life events, serious physical illness, or possibility of serious illness: (ex. cancer, death in family ,move).
Diagnostic criteria for OCD
According to American Psychiatric Association(2013), the diagnostic criteria for what constitutes OCD are that obsessive thoughts are distracting and unwelcome, causing the person to conduct repetitive behaviors that “are intended to prevent or reduce anxiety or distress, or to prevent some dreaded event or situation”. The DSM-5 also notes that other diagnostic criteria include that “obsessions or compulsions are time-consuming or cause significant distress/disruption in social, occupational or other important areas of functioning,” that obsessive-compulsive symptoms are not triggered by the physiological effects of a drug or a medical condition, and that the symptoms are synthesized(American Psychiatric Association,2013).
Psychotherapy and Psychopharmacologic treatment for OCD
The mainstays of treatment in OCD includes cognitive-behavioral therapy in the form of exposure and response prevention (ERP) and serotonin reuptake inhibiting medications and a tricyclic antidepressant depending on illness severity(Seibell,2014). Treatment with a skilled cognitive-behavioral/ERP can help patients make significant gains overall in level of functioning and quality of life(Seibell,2014). Medication management includes FDA approved medications for treatment of OCD are SSRIs, that include fluoxetine, fluvoxamine, paroxetine,sertraline and clomipramine, a tricyclic.However, Clomipramine has a higher side-effect burden than SSRIs. Therefore, an SSRI is recommended as first-line pharmacological treatment and has similar efficacy(Seibell,2014).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Patra, B. N., & Sarkar, S. (2013). Adjustment disorder: current diagnostic status. Indian journal of psychological medicine, 35(1), 4–9. https://doi.org/10.4103/0253-7176.112193
Seibell, P. J., & Hollander, E. (2014). Management of obsessive-compulsive disorder. F1000prime reports, 6, 68. https://doi.org/10.12703/P6-68
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
3 hours ago
Week 6 Main post
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Week 6 Main post
Adjustment Disorder vs Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Individuals with GAD find it difficult to control their worry. They may worry more than seems warranted about actual events or may expect the worst even when there is no apparent reason for concern (“Anxiety and Depression Association of America,” 2020). An Adjustment Disorder (AD) is an emotional or behavioral reaction to a stressful event or change in a person’s life. The reaction is considered an unhealthy or excessive response to the event or change within three months of it happening. Stressful events or changes in the life of a child or adolescent may be a family move, the parents’ divorce or separation, the loss of a pet, or the birth of a sibling. A sudden illness or restriction to a child’s life due to chronic illness may also result in an adjustment response (“Johns Hopkins Medicine,” 2020). The differences between GAD and Adjustment Disorder are that (AD) it is targeted more toward children and adolescents but it can be diagnosed for adults. With GAD, the anxiety and worry can be about many broad problems that the patient may be experiencing. Adjustment disorder typically has a pin pointed reason behind the anxiety they feel as in something has triggered the anxiety. Typically, with adjustment disorder, the patient will see a gradual decrease in anxiety after the situation goes away. GAD is continuous.
Diagnostic Criteria for GAD
When assessing for GAD, clinical professionals are looking for the following:
The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive.
The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another.
The anxiety and worry are accompanied with at least three of the following physical or cognitive symptoms (In children, only one of these symptoms is necessary for a diagnosis of GAD):
Edginess or restlessness
Tiring easily; more fatigued than usual
Impaired concentration or feeling as though the mind goes blank
Irritability (which may or may not be observable to others)
Increased muscle aches or soreness
Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep) (Glasofer, 2020).
Psychotherapy and Psychopharmacology
Treatment involves meeting regularly to talk with a mental health professional. The goal is to change a person’s thinking and behaviors. This approach has been successful in creating permanent change in many people with anxiety. It’s considered first-line treatment for anxiety disorders in people who are pregnant. Others have found that the benefits of cognitive behavioral therapy have provided long-term anxiety relief (“Healthline,” 2020). Medications can help enhance therapy. Some antianxiety medications such as Xanax, Ativan, and Klonopin are used but those need to be used short term. Antidepressants are also used such as Zoloft, Lexapro, Buspar, Paxil and Celexa, just to name a few. These are SSRI medications and are used most often. I should add that some lifestyle changes should be educated. Exercise can help lower anxiety and meditation. Avoiding extra caffeine could be helpful, (this one may be hard as coffee is the morning elixir). Most people can manage GAD with a combination of therapy, medication, and lifestyle changes.
Adjustment Disorders. (2020). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/adjustment-disorders
Generalized Anxiety Disorder. (2020). Retrieved from https://www.healthline.com/health/anxiety/generalized-anxiety-disorder
Generalized anxiety Disorder (GAD). (2020). Retrieved from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad#:~:text=Generalized%20Anxiety%20Disorder%20(GAD)%20is,difficult%20to%20control%20their%20worry.
Glasofer, D. R. (2020). Generalized Anxiety Disorder: Symptoms and Diagnosis. Retrieved from https://www.verywellmind.com/dsm-5-criteria-for-generalized-anxiety-disorder-1393