Obsessive Compulsive Disorders Case Study

Patient Information:
E.J. 15 year old. Caucasian. Female.
S.
CC: Dry, reddened hands/wrists
HPI: Ellie’s mother reports that, about one month ago, she noticed that Ellie’s hands and wrists were very dry and reddened. She has been giving her lotion to apply but nothing seems to help and she has become concerned and thinks she might have eczema. Mother reports that she has tried to watch Ellie's habits and hasn't noticed anything super out of the ordinary. However, it is unknown as to her habits when she is out of the home. While watching Ellie’s habits the mother states that she has noticed that Ellie goes to bed at 9 pm every night, wakes up at 6 am every day and she wears the same clothes on the same day each week.
Onset: Unknown but first
1045). Obsessions are considered intrusive thoughts or fears that can cause stress or anxiety to a person and compulsions are a repetitive actions or behaviors that are done because of the obsession(s) that one might have (Dunphy, Winland-Brown, Porter & Thomas, 2015, p. 1045). Stressors that can induce OCD type behavior could be developmental type transitions (such as first day of school) or family losses (such as a divorce of death of a loved one) (March & Cabrera,
Medications:
At this time, I would continue with her current medication for depression but would increase the dose. Responses from medications/therapy should be noticed within six weeks (Geller & March, 2012, p. 106). SSRI’s are first line in pharmacological treatment and have shown the best results in reducing OCD symptoms (Geller & March, 2012, p. 106).
Med: Zoloft Sig: 100 mg, 1 tab PO, daily Disp: 30 tabs, 3 refills (Geller & March, 2012, p. 107)
Conservative Methods:
OCD is best treated with a combination of Cognitive Behavioral Therapy (CBT) and an SSRI (Hay, Levin, Deterding & Abzug, 2014, p. 208). CBT is the first line for non-pharmacologic treatment and focuses on coping skills, stress reduction techniques and exposure-response therapy (Hay, Levin, Deterding & Abzug, 2014, p. 208).
A full psychiatric evaluation should be completed and should include a complete medical (with focus on the central nervous system), school, developmental and family history (Geller & March, 2012, p.