Coronavirus Disease-2019 (COVID-19) pandemic has been especially hard for children and adolescent’s mental health due to their inherent vulnerabilities and added stress of lockdown, mobility restrictions, school closure, absence of peer interaction. This case report highlights the unmasking of obsessive compulsive symptoms due to the COVID-19 pandemic stress and the role of inherent vulnerabilities in a 11-year-old female. The management of the index case emphasised upon age appropriate strategies for intervention. Although, Obsessive Compulsive Disorders (OCD) is not a stress disorder per se but the index case highlights the role of stress in manifestation of mental illness in vulnerable individuals favouring the biopsychosocial model for mental illness.
Obsessive–compulsive disorder (OCD) is a commonly encountered psychiatric illness. Cognitive behavior therapy (CBT)/exposure and response prevention (ERP) is first-line treatment option for OCD. When facilities are available, CBT/ERP monotherapy may be recommended in mild to moderately ill patients. However, in severely ill patients, the management comprising CBT and pharmacotherapy is more efficacious than single treatment alone. Behaviorists practicing ERP recommend that exposure in real-life situations (vivo) is more effective than in imaginative situations (vitro). Here, we present a case of a middle-aged female with obsessions regarding contamination by menstrual blood and compulsions of checking and cleaning, causing marked sociooccupational deficit. The index patient who was suffering from debilitating form of OCD failed to respond to pharmacotherapy alone and later with combination of pharmacotherapy; brief in vivo flooding and ERP in vitro responded well; which is sustained at 6 months' follow-up.
Background: Health-care providers (HCP) engaged in demanding work like being involved in the care of COVID-19 positive and suspected cases are likely to have a lot of stress, anxiety, depression, and other mental health issues. It will be noteworthy to have an idea about the magnitude of the mental health problems in them to formulate effective intervention strategies for their well-being. Aims and Objectives: The aim of this study is to determine whether frontline HCP engaged in the treatment and care of COVID-19 positive and suspect cases experienced increased mental health problems. Methodology: Two hundred and fifty-one frontline HCPs engaged in COVID-19 duty and 97 nonfrontline (controls) HCP were assessed and compared using tools like General Health Questionnaire 12, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. Appropriate statistical tools such as analysis of variance and Chi-square were used. Results: Frontline HCP who were directly involved in COVID-19 duty had a higher proportion (28.3%) of psychological morbidities as compared to 19.6% among controls; HCP-frontline had significantly 2.17 times chances of having psychological distress compared to HCP controls. Among, HCP-frontline 13.1% had clinical depression, whereas in the HCP control, this was 6.2%. Further, 20.3% of HCP frontline and 10.3% of HCP control had clinical anxiety, and the difference between the two groups was statistically significant ( P = 0.0011). Conclusion: Frontline HCPs working in demanding work such as COVID-19 patient care are susceptible to psychological distress, anxiety, and depression which warrant urgent attention.
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