{"id":3425,"date":"2013-08-30T16:30:42","date_gmt":"2013-08-30T13:30:42","guid":{"rendered":"http:\/\/seragpsych.com\/wordpress\/?p=3425"},"modified":"2013-08-30T16:30:42","modified_gmt":"2013-08-30T13:30:42","slug":"hints-on-managing-obsessive-symptoms-in-schizophrenic-patient","status":"publish","type":"post","link":"https:\/\/seragpsych.com\/wordpress\/hints-on-managing-obsessive-symptoms-in-schizophrenic-patient\/","title":{"rendered":"Hints On managing Obsessive symptoms in Schizophrenic Patient"},"content":{"rendered":"<h2><em><span style=\"text-decoration: underline; color: #ff00ff;\">Insight:<\/span><\/em><\/h2>\n<p>&nbsp;<\/p>\n<p>\u2022 Obsessive-compulsive disorder (OCD) with poor insight should be considered a severe form of OCD and not be mistaken for a primary psychotic disorder; a careful history is required to ascertain for insight in previous OCD exacerbations<\/p>\n<p>\u2022 OCD with poor insight may respond to treatment with an SSRI without the addition of an adjunctive antipsychotic, or preferentially to adjunctive antipsychotic added to an SSRI ; because some individuals with OCD take longer to respond to SSRIs, a therapeutic trial of an SSRI at optimized dosages for at least 8 to 12 weeks should be tried before the addition of adjunctive antipsychotic medication<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2><em><span style=\"text-decoration: underline; color: #ff0000;\">Primary OCD Vs Secondary to atypicals:<\/span><\/em><\/h2>\n<p>&nbsp;<\/p>\n<p>\u2022 Primary OCD should be distinguished from de novo obsessive-compulsive sympoms (OCS) induced by atypical antipsychotics\/serotonin-dopamine antagonists (SDAs); this highlights the importance of a careful history rather than mere cross-sectional examination<\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"text-decoration: underline;\"><span style=\"color: #ff0000; text-decoration: underline;\">Evaluate Before Medication :<\/span><\/span><\/h2>\n<p>\u2022 Persons with schizophrenia should be evaluated for OCS\/OCD before starting or switching to an SDA and monitored prospectively for the emergence of de novo OCS<\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"text-decoration: underline;\"><span style=\"color: #ff0000; text-decoration: underline;\">Manage Induced Obsessive Symptoms:<\/span><\/span>\u2022<\/h2>\n<h2>SDA-induced OCS may be dose-dependent; in managing treatment emergent OCS, whether to reduce the SGA dose, switch to a different antipsychotic, or continue the atypical antipsychotic and treat the de novo OCS is a matter of clinical judgment; the decision should entail a risk\/benefit analysis that considers the degree of antipsychotic response to the SGA and the severity of treatment emergent OCS, among other factors<\/h2>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2><em><span style=\"text-decoration: underline; color: #ff0000;\">If Pure OCD is Co- Morbid with Schizophrenia:<\/span><\/em><\/h2>\n<p>&nbsp;<\/p>\n<p>\u2022 As with pure OCD, OCD comorbid with schizophrenia may respond to treatment with an SSRI and\/or adjunctive cognitive-behavioral therapy; first-line treatment for patients who meet criteria for both disorders consists of an antipsychotic and an SSRI<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Insight: &nbsp; \u2022 Obsessive-compulsive disorder (OCD) with poor insight should be considered a severe form of OCD and not be mistaken for a primary psychotic disorder; a careful history is required to ascertain for insight in previous OCD exacerbations \u2022 OCD with poor insight may respond to treatment with an SSRI without the addition of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[459],"tags":[485,995,154,649,992,808,158,155,815,994,601,49,738,991,161,1503,993,486,528,489,183,134,62,747,490],"class_list":["post-3425","post","type-post","status-publish","format-standard","hentry","category-459","tag-adel","tag-antipsychotic","tag-anxiety","tag-depression","tag-disorder","tag-emotional","tag-examination","tag-fear","tag-focus","tag-generation","tag-improve","tag-individual-psychothterapy","tag-negative","tag-obsessive-compulsive","tag-psychiatric","tag-psychiatry","tag-second","tag-serag","tag-seragpsych","tag-seragpsych-com","tag-skills","tag-speed","tag-spirit-and-excercise","tag-symptoms","tag-thinking","entry"],"_links":{"self":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/3425","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/comments?post=3425"}],"version-history":[{"count":1,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/3425\/revisions"}],"predecessor-version":[{"id":3426,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/3425\/revisions\/3426"}],"wp:attachment":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media?parent=3425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/categories?post=3425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/tags?post=3425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}