Progression of Neurotic to Psychiatric Illness and its Management Strategies: A Case History

¹Assistant Professor, Department of Clinical Psychology, Central India Institute of Mental Health and Neurosciences, Rajnandgaon, Chattisgarh, India

²Assistant Professor, Department of Psychology, Government Degree College, Dhindhui, Patti, Pratapgarh, Uttar Pradesh-230138, India

*Corresponding Author: Akanksha Chaurasiya, Assistant Professor, Department of Psychology, Government Degree College, Dhindhui, Patti, Pratapgarh, Uttar Pradesh-230138, India. Phone: 9026203128; Emails: [email protected]; [email protected]

Received Date: September 15, 2022

Published Date: October 20, 2022

Citation: Chaurasiya A, et al. (2022). Progression of Neurotic to Psychiatric Illness and its Management Strategies: A Case History. Mathews J Psychiatry Ment Health. 7(2):33.

Copyrights: Chaurasiya A, et al. © (2022).

ABSTRACT

Purpose: The purpose of this case report is to demonstrate the case of progression illness and its management plan. Client description: A 42-year-old male patient with a “Specific phobia with Obsessive Compulsive Disorder with Moderate depressive episode with paranoid schizophrenia”. During the interview, the patient reported that he is having fear of crowded places, height & blood, low mood, low self-esteem, repetitive thoughts, Nightmares about a snake, excessive cleaning rituals, suspiciousness towards surrounding people, and hearing voices. Measures and outcome: The Psychological assessment TCI indicates “obsessive-compulsive personality disorder”, Rorschach fulfilled the ‘coping deficit index’, TAT indicates fear of the environment, people or negative judgment by others, felt the anxiety of disapproval and punishment, Y-BOCS indicates “Moderate category of Obsession” and “Mild category of compulsive symptoms”, BDI-II indicates “Moderate depressive symptoms”, HAM-A indicates “Mild anxiety symptoms” and BPRS indicates “Mildly ill”. The MSE revealed that the patient had checking & sexual obsession, dirt & contamination obsession and cleaning compulsions, Agoraphobia, claustrophobia, hemophobia, acrophobia, hypnogogic hallucination, delusion of reference, delusion of persecution and delusion of infidelity, depressed mood and affect, suicidal thoughts, fair judgment with Grade 4 insight. The patient was diagnosed with “Specific phobia with obsessive-compulsive disorder with Moderate depressive episode with paranoid schizophrenia” by a psychiatrist and was prescribed Pharmacological and psychological treatment. Management: The pharmacological treatment through SSRI continued and specific symptom-based psychological therapy and intervention including relaxation therapy has been planned and given to the patient. Implications: This case study reinforces the importance of a thorough psychological evaluation to rule out other disorders. Further, it also presents a case with the progression of illness and treatment plan.

Keywords: Comorbid disorders, Obsessive Compulsive disorder, Psychiatric disorder, Multiple phobias, Progression of illness