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Suggest Treatment For OCD And Convulsion Problem
Question: My Son diagnosed of OCD since two years. He is 18. He has convulsion problem for short stint at the age of six and which didnt reoccur after his age of 7. At school level he was relatively slow, shy, not a good performer and had a lots of ambition and couldnt perform which led to frustration and rigidness. At XXXXXXX school level till 10th it went relatively normal but in Class XI I was transferred from XXXXXXX to XXXXXXX and he initially didnt show any change but in less than 3 months of stay at XXXXXXX his behavior got wild and he developed kitchen phobia and got into the cleanliness issue and started interfering too much in kitchen affair for not allowing this or that and not allowing the utensils and becoming to impulsive and possessive. He has targeted his mother. Irritates her, interferes in every minute details and in-spite washing himself ask his mother to wash hands on every activity she does. He has lost interest in studies. Could not perform in class XII board. Showed here to many psychiatrist and other pathi's.... he doesn't cooperate for medicine, even if he does he puts lot many preconditions... I am worried.. every day he come up with new idea of troubling and irritation.
Brief Answer:
Short term hospitalization is option
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query with keen interest and understand the concerns.
Although by large I agree with diagnosis of OCD but there are few indications as per available history which points toward psychosis. Even if we consider a diagnosis of OCD it will be better to call it OCD with poor insight, in which patient remains unaware of the problem and deny for the treatment. I must acknowledge here that only after detailed history taking from multiple stake holders a proper diagnosis can be made.
I like to assure you that the both convulsion and OCD are independent problem and not much related.
But the various psycho social stressors, poor frustration tolerance, bullying and change of environment may be associated with development of OCD.
In classical OCD most of the patients do not interfere in other peoples activities and generally ask for treatment. They also have good compliance and follow the instruction of therapist or doctor.
With diagnosis of OCD with poor insight or OCD with psychosis, it becomes immensely essential to give both Anti OCD and anti psychotic medication.
As there is problem with taking medication, I think a short hospitalization will be appropriate for him and your family. Other than usual benefits he will have proper diagnosis, which I hope will lead us to proper treatment. Other than medications for OCD a very special kind of therapy, known as Exposure and Response Prevention (ERP) is effective. With hospitalization it will be easy for you to get treatment from both psychiatrist and therapist.
Bending against his pressures or conditions is not going to help anybody and it is likely that his ritualistic behavior will be accentuated. Keeping this point in mind it is suggested to take the balance approach when dealing with child.
Please note that OCD is one of the most difficult to treat psychiatric disorder and it takes months for any medicine to have full effect. If he takes medication for one or two months, there is very low chance that he will feel improvement.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Dr Ashok Kumar
Short term hospitalization is option
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query with keen interest and understand the concerns.
Although by large I agree with diagnosis of OCD but there are few indications as per available history which points toward psychosis. Even if we consider a diagnosis of OCD it will be better to call it OCD with poor insight, in which patient remains unaware of the problem and deny for the treatment. I must acknowledge here that only after detailed history taking from multiple stake holders a proper diagnosis can be made.
I like to assure you that the both convulsion and OCD are independent problem and not much related.
But the various psycho social stressors, poor frustration tolerance, bullying and change of environment may be associated with development of OCD.
In classical OCD most of the patients do not interfere in other peoples activities and generally ask for treatment. They also have good compliance and follow the instruction of therapist or doctor.
With diagnosis of OCD with poor insight or OCD with psychosis, it becomes immensely essential to give both Anti OCD and anti psychotic medication.
As there is problem with taking medication, I think a short hospitalization will be appropriate for him and your family. Other than usual benefits he will have proper diagnosis, which I hope will lead us to proper treatment. Other than medications for OCD a very special kind of therapy, known as Exposure and Response Prevention (ERP) is effective. With hospitalization it will be easy for you to get treatment from both psychiatrist and therapist.
Bending against his pressures or conditions is not going to help anybody and it is likely that his ritualistic behavior will be accentuated. Keeping this point in mind it is suggested to take the balance approach when dealing with child.
Please note that OCD is one of the most difficult to treat psychiatric disorder and it takes months for any medicine to have full effect. If he takes medication for one or two months, there is very low chance that he will feel improvement.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanx Dr XXXXXXX XXXXXXX for instant and suitable reply with positive approach. Actually, while undergoing treatment with Dr Tambi, CBT sessions took place ( five) and the concern Psychiatrist suggested that since he didnt show any improvement so Magnetic Simulations were recommended. Whether it will help in such case. Further , in most the literature, I have read or heard that the the affected ptient s involves in removing his obsession to his satisfaction, bu in this case, he aks his mohter too often to wash hands, lot many restriction and non usage of litchen and related items due to his inhibitions. How to deal in day to day life. If we dont agree to his option, things are tense and worse and if we agree, I am at stake of putting too much of expenditure on same things again and again and resulting and new inhibitions .....
Are there any rehabilitation or cure centre, where he can be admitted then kindly suggest prefereably at XXXXXXX
XXXX
Are there any rehabilitation or cure centre, where he can be admitted then kindly suggest prefereably at XXXXXXX
XXXX
Brief Answer:
You can seek indoor treatment
Detailed Answer:
Dear XXXXXXX
Thank for reverting back to me.
Since he is not responding to conventional form of therapy trying for magnetic stimulation is one option.Not every body have magnetic stimulation in XXXXXXX and there is limited research on its usefulness. I must acknowledge that Magnetic stimulation have not been studies in patients with OCD and no one can guarantee that it will be effective or not.
Rather than going for a therapy which has questionable value, it will be appropriate to keep him for electo convulsive therapy or ECT. We all know about stigma attached with it but this is the most effective treatment in the world for various psychiatric disorders who fail to respond to other kind of treatment.
Other than that if things are becoming very difficult, it will be appropriate to keep him in indoor ward for further treatment. I am not supposed to name a hospital but I am compelled to so as psychiatric center, attached to SMS medical college is only better option in XXXXXXX
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
You can seek indoor treatment
Detailed Answer:
Dear XXXXXXX
Thank for reverting back to me.
Since he is not responding to conventional form of therapy trying for magnetic stimulation is one option.Not every body have magnetic stimulation in XXXXXXX and there is limited research on its usefulness. I must acknowledge that Magnetic stimulation have not been studies in patients with OCD and no one can guarantee that it will be effective or not.
Rather than going for a therapy which has questionable value, it will be appropriate to keep him for electo convulsive therapy or ECT. We all know about stigma attached with it but this is the most effective treatment in the world for various psychiatric disorders who fail to respond to other kind of treatment.
Other than that if things are becoming very difficult, it will be appropriate to keep him in indoor ward for further treatment. I am not supposed to name a hospital but I am compelled to so as psychiatric center, attached to SMS medical college is only better option in XXXXXXX
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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