Comorbidity Subtypes and specifiers for each disorder. In reading each of these aspects related to a disorder, you will become more adept at using the DSM-5 and display advanced clinical formulation abilities. It is also advisable to carefully read each coding note as well as coding and reporting procedures for each disorder. As you shift from using the DSM-IV-TR to the DSM-5, remember that the DSM-5 is intended to serve as a practical, functional, and flexible guide for organizing information that can aid in the accurate diagnosis and treatment of mental disorders.
Healthcare professionals should therefore ensure continuity of care and minimise the need for multiple assessments by different healthcare professionals.
There should be clear, written agreement among individual healthcare professionals about the responsibility for monitoring and treating people with OCD and BDD. A written copy of this agreement should be given to the patient. This should be in collaboration with the patient, and where appropriate: Patients should have the opportunity to make informed decisions about their care and treatment.
Where patients do not have the capacity to make decisions, or children or young people are not old enough to do so, healthcare professionals should follow the Department of Health guidelines Reference guide to consent for examination or treatment .
Provision of information, treatment and care should be tailored to the needs of the individual, culturally appropriate, and provided in a form that is accessible to people who have additional needs, such as learning difficulties, physical or sensory disabilities, or limited competence in speaking or reading English.
In some cases, particularly with children and young people, when the symptoms of OCD or BDD interfere with academic or workplace performance, it may be appropriate to liaise with professionals from these organisations.
Assessment should include the impact of rituals and compulsions on others in particular on dependent children and the degree to which carers are involved in supporting or carrying out behaviours related to the disorder. If this is carried out, the parent should be kept informed at every stage of the assessment.
It provides a framework in which to organise the provision of services in order to identify and access the most effective interventions see Figure 1. The guidance follows the steps in the figure. At all stages of assessment and treatment, families or carers should be involved as appropriate.
This is particularly important in the treatment of children and young people with OCD or BDD where it may also be helpful to involve others in their network, for example teachers, school health advisors, educational psychologists, and educational social workers.
Relatively few mental health professionals or GPs have expertise in the recognition, assessment, diagnosis and treatment of the less common forms of OCD and BDD. This team would perform the following functions: Do you wash or clean a lot?
Do you check things a lot? Is there any thought that keeps bothering you that you would like to get rid of but can not?
Do your daily activities take a long time to finish? Are you concerned about putting things in a special order or are you very upset by mess? Do these problems trouble you? Part of the risk assessment should include the impact of their compulsive behaviours on themselves or others.
Other comorbid conditions and psychosocial factors that may contribute to risk should also be considered. These themes are common in people with OCD at any age, and are often misinterpreted as indicating risk. Do you worry a lot about the way you look and wish you could think about it less?
What specific concerns do you have about your appearance? On a typical day, how many hours a day is your appearance on your mind? What effect does it have on your life? Does it make it hard to do your work or be with friends?
If risks are identified, all professionals involved in primary and secondary care should be informed and appropriate risk management strategies put into place. They should help provide training opportunities for cosmetic surgeons and dermatologists to aid in the recognition of BDD.
The difference in the treatments at the higher levels will reflect increasing experience and expertise in the implementation of a limited range of therapeutic options.
For many people, initial treatment may be best provided in primary care settings. Irrespective of the level of care, the following recommendations should be taken into account when selecting initial treatments for people with OCD or BDD.
The specific recommendations on how to provide these treatments follow in the subsequent sections. But individuals mature at different rates and young adults are at a higher background risk of suicidal behaviour than older adults.
Hence, young adults treated with SSRIs should be closely monitored as a precautionary measure. By this definition, most group treatments are defined as low intensity treatment less than 10 hours of therapist input per patientalthough each patient may receive a much greater number of hours of therapy.
Low intensity treatments include:Obsessive compulsive disorder (OCD) is a serious mental health condition that causes individuals to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ and/or ‘compulsions’. Cognitive abilities include perception, memory, judgment, perceptual speed, spatial manipulation and reasoning.
Both cross sectional and longitudinal studies have shown that different cognitive abilities have different developmental trajectories across the lifespan, and may be grouped into two broad types.
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Program Summary: This course explores alcohol use disorder and the medications approved for treating alcohol use disorder including Disulfiram, Naltrexone, and Acamprosate.
Medication assisted treatment can be an effective element of treatment for moderate or severe alcohol use disorder and this course explores screening and assessment, developing a treatment plan, medication-assisted.
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