Indian Journal of Health and Wellbeing

Shweta Jha ¹

Affiliations
1 Manipal University, Manipal, IN

Abstract

A 2 year 11 month old child born of non- consanguineous marriage; with full time normal delivery in hospital. Presented to us with family history of autism and ADHD in 2nd degree cousins and she had complaints of absence of social smile, lack of eye to eye contact, lack of awareness of others with impaired speech and stereotypic play activity, and spinning objects. Highly distracted, irritable, poor concentration and attention; with no history of hearing and speech impairment and normal development until 12 month when the present symptoms were noted.

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Shweta Jha ¹

Affiliations
1 Kasturba Medical College, SOHAS, Manipal University, Manipal, Karnataka, IN

Abstract

Researchers have concluded that lifetime prevalence for schizophrenia is 1% and for obsessive-compulsive disorder (OCD) it is 2-3%. Co-morbidity rates for OCD in the schizophrenia population are substantially higher than what would be expected to occur randomly. In the schizophrenic population, the reported prevalence of clinically significant orthopedic clinical specialist and of OCD ranges from 10% to 52% and from 7.8% to 26%. Here we report a case of a 20-year-old, single Hindu female, from MSES, PUC failed, pre-morbidly with difficult temperament, diagnosed with past history of paranoid schizophrenia and currently diagnosed with OCD. Mostly comorbid conditions are difficult to treat but in the present case: Psychotic symptoms were reported to be in control with medication, but patient never returned to pre-morbid level of functioning and since past 3 months she started having repetitive, intrusive thoughts which were distressing and also decreased her day to day life functioning, for treating OCD researches have suggested that exposure and response prevention (ERP) methods of treatment id most adaptable, A meta-analysis by Eddy et al., (2004) examined data from 15 clinical trials. Treatments included ERP, computed tomography (CT), and active and passive control conditions. Overall, approximately two-thirds of the patients who completed treatment improved, findings were stronger for ERP than CT, and individual therapy was more effective than group therapy, but in the present study we used habituation training to decrease the response to the stimulus. We initiated with this because we still had doubt that these symptoms could be part of her hallucinations as there was a past history of schizophrenia; but as patient was not able to describe very clearly, we started with habituation training, so that the repeated presentation of the stimulus results in the decline of the behavior and make her less responsive or reactive to the stimuli. Habituation training is not a standard treatment method for OCD; but in our study we found an improvement in patient personal, social and occupational level and level of intensity of thoughts, follow-up showed that the improvement was maintained for 6 month; after which contact with the patient was lost.

Keywords

ERP, Habituation, Obsessive Compulsive Disorder.

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