Pediatric Anxiety and OCD Case Analysis (Coursework Sample)

Pediatric Anxiety and OCD Case Analysis Student’s Name Department, Institutional Affiliation Course Name & Number Instructor Due Date Pediatric Anxiety and OCD Case Analysis Summary Cora, a seven-year-old who had a normal birth and early childhood, has been going through mental disturbances characterized by anxiety and phobic episodes. Her early learning was in a private kindergarten, and she grew to love it, but that changed when she was transferred to a public elementary school due to financial constraints. She is anxious and tearful and exhibits aggressive behaviors like punching the wall, chewing holes in her shirt, and throwing herself down because she does not want to go to the new school, resulting in missing school days. During this time, she has adopted new routines, such as being tucked by her mother on the left side and father on the left and styling her hair the same way before going to bed. She is obsessed with her mother's lupus illness, as evidenced by her constant inquiry of dreaming about her funeral. Finally, she is dog-phobic and afraid of expressing herself in public, in addition to wetting her bed daily. Provisional Diagnosis Cora's provisional diagnosis is Obsessive-Compulsive Disorder (OCD), one of the Obsessive Compulsive and related disorders. The possible differential diagnosis is oppositional defiant disorder, (ADHD), Autism Spectrum Disorder, and depression. Justification: DSM-5 Criteria for OCD Cora's diagnosis meets the DSM-5 criteria for OCD and related disorders. She experiences intrusive thoughts about her new school, demonstrated by her lack of sleep and questions about the school environment. She is also obsessed with her mother's condition and possible death as she keeps talking about her funeral. Another criterion that the diagnosis meets is the presence of repetitive behaviors such as brushing her hair the same style every night and requiring her to be tucked to sleep routinely (U.S. National Library of Medicine, 2024). Additionally, some of Cora's behaviors are aimed at preventing a dreaded event, which is going to the new school and her mother's possible death. For example, she digs her face, pulls her hair, screams, punches the walls, and throws herself on the floor when a new school day approaches because she does not want to go. Her obsessions and compulsions have impacted her social and physical functioning as she is afraid of writing or talking in public, fears dogs, and wets the bed every day. Basis for Early Identification and Intervention Cora is not too young to be diagnosed at seven years old because she already had normal early childhood growth and learning. According to Rapee et al. (2023), obsessive-compulsive disorders can be diagnosed as early as seven years but could show symptoms earlier. Treatment outcomes for the disorders are better when the disease is identified and intervened earlier; therefore, Cora should be diagnosed as early as now so that she can get the help she needs through therapy and medication. Psychiatric Scales or Assessment Tools for the Patient Several Psychiatric scales can be used with Cora and her parents to assess her condition. These include: Obsessive-compulsive inventory: This scale was developed by Foa et al. in 2010 and consists of 21 items about current and past obsessions and compulsions rated on a Likert scale (Abramovitch et al., 2022). There is a version for children between 7 and 17 years old, and an adult version is suitable for Cora's parents. Children's Yale-Brown obsessive-compulsive scale (CY-BOCS): It consists of ten items used to assess the severity of the disorder. Responses to these items range from 0, indicating none, to 4, indicating severe. It can be used with Cora and her parents. Multidimensional anxiety scale for children: This self-expressing measure consists of 39 items where the patient answers questions about their anxiety behaviors on a scale of 0 to 3 (Abramovitch et al., 2022). 0 represents "never true about me," while 3 is "often true about me." This scale is suitable for the patient only because it is for children. Treatment Plan for Medications The treatment plan will combine face-to-face therapy sessions and medication. The therapy session includes behavior and cognitive interventions to help Cora deal with her fears and worries and cope with the changes. Family therapy will also be necessary to guide Cora's parents on how to help her cope with the stresses. The medication will be Selective serotonin reuptake inhibitors (SSRIs) for reducing stress. Medication Issues Target symptoms: anxiety, obsessive, compulsive and phobic symptoms Receptors affected: 5-hydroxytryptamine (serotonin), 1A (HTR1A), and B (HTR1B) (Sangkuhl et al., 2010) Psychiatric and system effects: Dizziness, headache, nausea, legarthy, and aggression Possible parental concerns: Increased risk of more stress and depression. School-Based Treatment Plan A peer understanding program will help Cora's schoolmates and teachers understand her condition and support her through. It will also help avoid stressful situations at school, including The International OCD Foundation (OCDF) excessive homework or physical activity. Implications for Families Families with children and adolescents with OCD experience significant changes in their everyday lives as they try to fit their lifestyles and schedules to support their children. They may experience stress and physical strain due to the compulsive symptoms and demanding treatment plans. Mother's Health ...