The Symptoms Exhibited by the Patient
Exhibited symptoms include:
- Fear of infectious diseases such as HIV;
- The patient washes his hands up to 30 times a day;
- Avoiding touching object outside his home;
- Unmotivated fear of disturbing people around;
- Intrusive images of hitting someone;
- Apologizing when fears of sounding rude;
- Fear of flooding the neighbors;
- Inability to controls his impulses.
The symptoms described in the case most clearly represent obsessive-compulsive disorder (OCD).
The Summary of the Symptoms Exhibited by the Person
The patient in the described case demonstrates OCD symptoms characterized by persistent obsessive thoughts and an uncontrollable desire to perform repetitive actions. In particular, the symptoms are exhibited by Samuel King include obsessions related to contamination (fear of HIV, fear of contamination outside the home, fear of disturbing people or being rude, fear of flooding the neighbors), aggressions (intrusive images of hitting someone), symmetry (monitoring the precise level of water). The patient also shows multiple compulsive symptoms, including excessive hand washing, avoidance of touching objects outside the home, mental compulsion (apologizing for fear of being rude). Moreover, the obsession with the idea of infectious infections forces the patient to use bleach to disinfect his hands, which is even expressed in his smell. Additionally, the patient is unable to control the symptoms, which disrupts and diminishes the quality of his daily life. Avoiding contamination can also lead to social isolation and loneliness, as the patient fears contamination.
Two Treatment Options That Would Be Appropriate to Treat the Person
The main two options of OCD treatment are medications and psychotherapy, which are appropriate in the patient’s situation.
- Psychotherapy. Psychotherapeutic treatment of OCD involves the use of Exposure and response prevention (ERP), which is a form of Cognitive behavioral therapy (CBT). The therapy technique of the chosen therapy is thus classical conditioning. In this method, people with OCD symptoms are placed in a situation where they are constantly exposed to their fears and objects of obsession. Patients are asked not to commit compulsive actions, which as a result, reduces their level of anxiety. First, Samuel needs to make a list of his obsessions in order to identify the least fearful of them to initiate therapy. Based on this list, the therapist will give Samuel tasks related to his obsessions (touch the doorknob). Next, the therapist will ask him to wait before performing the compulsive action (washing his hands). Thus, gradually the time between the manifestation of obsession and the compulsive action will increase, and the therapy will have an effect. With the fear of flooding, Samuel will need to try not to control the water level. The more difficult part of therapy is dealing with the fear of disturbing and being rude. Samuel will need to control his mental manifestations and not apologize to people, so such symptoms and symptoms of aggression require medication. When dealing with aggression, fear of flooding, disturbing, and being rude systematic desensitization should also be used. Samuel, under the supervision of the therapist, will try to think about his obsessions and maintain a relaxed state. In this situation, it may also be necessary to work with Samuel’s social environment, which should help in controlling the manifestation of compulsive behavior.
- The main medications which should be used are antidepressants such as Clomipramine (Anafranil), Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil, Pexeva). Antidepressants have a number of side effects and take about two months to start working. Depending on the patient’s response to medication, the most appropriate drug is selected. It is most important to control the disease with the lowest possible dosage. Samuel will need to inform the therapist about the serious side effects of a possible medication change and to control his well-being.
Treatment Options as the Best Course of Action
In the case of Samuel, a combination of psychotherapy and medication is necessary since the patient exhibits quite severe symptoms. What’s more, antidepressants are needed to relieve the symptoms of aggression that Samuel has. Psychotherapeutic treatment, in this case, will be more effective when using medication support. Additionally, Samuel will find it easier to exercise self-control over his mental compulsions. Thus, in relation to the described case, it is recommended to use both ERP and medications.