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Scenario: Patient is 10 y/o Caucasian male who was brought into the clinic by his mother. His mother reports that her son has been exhibiting a lot of worry and nervousness for two months. She noticed he worries a lot about “germs” and he is constantly washing his hands. He kept to himself at home and at school because he doesn’t want to “catch germs”. Patient was also reported to be avoiding school and not playing with his friends. During your assessment with him, patient is noticed to be very nervous about his dirty hands and requested to go wash a couple of times. Patient informed you that the only way to feel better is to wash his hands. Diagnosis is OCD.
1. Link specific symptoms to DSM-5 criteria to support the diagnosis.
2. Begin fluvoxamine immediate release 25mg orally at bedtime
3. Discuss the rationale for this medication
2 weeks later, Ms. B reported that patient is doing better (25%). Fluvoxamine was increased to 50mg.
1. Discuss the rationale for the increase in dosage
4 weeks later Ms. B reported 50% improvement in symptoms
2. Will it be necessary to augment treatment with psychotherapy? Explain why or why not.