Obsession

OBSESSION By Dragan Nikolic

• ObsessionRepetitive, invading, persistant beliefs/thoughts that are imposible to be ignored by a person.

Most common Obessive disorder:

• Obsessive-Compulsive Disorder (OCD)Anxiety disorder of intrusive thoughts fear, apprehension, worry, and uneasiness.

Combination of:- Obsession

- Compulsion

Obsessive – Compulsive - DisorderOBSESSION

OBSESSION

Contamination: body fluids, germs, dirt…

Other: getting ill/disease, superstitious – numbers, colors…

Perfectionism: exactness, evenness, know, remember…

Unwanted sexual thoughts: forbidden, perverse, aggressive…

Loosing control: fear that one can hurt himself, others …

Harm: fear of being responsible for wrong things happened…

Religious: concerns of offending God, blasphemy, morality…

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COMPULSION

Checking that: did not/will not harm itself/others…

Mental Compulsions: mental review, praying to prevent…

Washing & Cleaning excessively: hands, bathing…

Repeating: routine activities, body movements…

Other: putting things in order, getting reassurance…

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CausesOCD

Because of changes in one’s body natural chemistry and brain functions + it may have some genetic component, although specific gen is still not identified.

Biology

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Exact cause

- Abusse,- Ilness,- Death of a family

member or a friend,

- Relationship worries,

- Work or school stress or changes,

- Changes in living situation.

Environment

According to multiple researches and many studies exact cause is still unknown unfortunately.

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Larger studies from multiple sites are needed to establish accurately the prognosis associated with modern treatment methods.

OCDPrognosis

Usually begins before age of 25, childhood & adolescence.• According to 1988 research: 85% continuous course with waxing

& warning symptoms, 10% deteriorative course, 2%episodic course.• According to 1995 research:1.5y to 5y research – out of 23

children on medication, only 4 were free of OCD,

8 had subclinical symptoms,11 remaining had chronic or episodic

OCD.

MedicationsOCD

Fluoxetine(Prozac ®)

Sertraline(Zoloft ®)

Clomipramine

(Anafranil ®)

Citalopram(Celexa ®)

Fluvoxamine(Luvox CR ®)

Parexotine(Pexeva ®, Praxile ®)

Medications (cont’d)OCD

1Stomach problems, sleep disturbance, sweating and reduced sexual interest.

Side effects

Suicidal thought can increase in some cases in children, teenagers, and young adults under 25y/o.

Suicide risk

3Danger if interact with alcohol, other medications, foods, or some other substances.

Interactions with other substances

Medications that are used to help control OCD are most comonly antidepresants.

More than one is tried, Combination with antipscyhotics, Therapy not to be stoped before

consultation with doctor, Not addictive; however, physical

dependance may happen.

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• Nurse is the person that creates therapeutic environment and helps people to return to they normal life as fast as its possible,

• Nurse must be emotionally available, able to listen, nonpunitive, supportive, understanding, and encouraging.

OCDNursing Interventions

Nursing Interventions (Cont’d)OCD

Nurse is known as a pillar of stability and consistency by working closely with clients. Nurse is there to provide different types of assistances such as:

Advising assistance

Emotional assistance

Physical assistance

Assisting the person with OCD to perform routine physical care include:

Handling inappropriate or dangerous behaviors.

Assisting sleep-deprived client to sleep.

Assisting with ADL’s.

Administering prescribed medications, observing for side effects, and teaching clients about medications.

Administering physical treatment, as ordered by doctor.

Nursing Interventions (Cont’d)OCD

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There are many ways in which nurse can be emotionally supportive such as:

Introduce himself/herself and offer to shake hands.

Be even-tempered and uncritical – the person is ill.

Establish rapport (harmonious relationship), and here are some aspects of positive nurse-client relationships:

Be truthful but not brutally so.

Have poise-it influence confidence in both nurse and client

Nursing Interventions (Cont’d)OCD

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* Be an interested listener. Sit down to visit the clients. Do not stand over them.

Display empathy. It is very important to try to understand how clients feels.

Appreciate individual differences.

Set appropriate limits.

Concentrate on client’s strengths and not on weakness.

Treat adults as adults

Reward positive behaviors and step toward wellness.

Nursing Interventions (Cont’d)OCD

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* Do not force client to have a long interview if it is uncomfortable…

Create therapeutic and safe environment within the mental health setting.

Provide leadership in socialization activities with person or group.

Conduct remotivation sessions.

Provide emotional support to the client and family.

Aid in group therapy sessions

Assist the client and family to access other resources, such as Alcoholics Anonymous, a community drop-in center or community social worker.

Nursing Interventions (Cont’d)OCD

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1. Alcohol usage is not advised, especially in the initial phase of medication therapy.

2. Driving is not advised during therapy because drowsiness, dizziness, or cognitive impairment can be present.

3. Alcohol can interact with other medications in negative way and may alter the therapy..

Advising assistance

OCDNursing Inteventions (Cont’d)

Interaction with

medications

DrivingAlcohol

The Nurse

SummaryOCD

As a pillar of stability nurse’s help is vital in helping clients and their needs in overcoming OCD’s and its symptoms, and as that nurse has significant role in taking care of mentally ill people.

• OCD and its course can vary,• Symptoms can come and go (people can feel

that symptoms are disappearing or becoming worse over time),

• Avoiding triggering situations + medications may help in calming people with OCD,

• Combinig multiple medications can be dangerous in some situations and people should be aware of that.

THANK YOU!

Dragan Nikolic