Author: Rohit Kumar

Phobia-Management


Phobias-Management


  • Pharmacotherapy – BDZs, SSRIs
  • Psychotherapy – Behavior therapy is the most effective
  • Systematic Desensitization – [Exposure / Relaxation] Best Evidence in T/T of Phobias
  • Therapeutic graded exposure [Exposure and response prevention]
  • Flooding [Implosion]- Exposed in Most severe form
  • Modeling [Participant modeling]- Therapist himself makes contact with phobic stimulus

Social Anxiety Disorder [Social Phobia]:

  • Fear of social situation including contact with strangers
  • Afraid of embarrassing themselves

OCD-Management & prognosis


OCD-Management & prognosis


Management:

Pharmacotherapy:

  • First Line – SSRIs and Clomipramine [adverse side effect profile]
  • If first line fails then antipsychotics [Haloperidol, quetiapine, risperidone, olanzapine]
  • Other Drugs [Venlafaxine, Lithium, valproate and carbamazepine]

Psychotherapy:

  • Cognitive Behavior therapy [Exposure & Response prevention]
  • Desensitization, thought stopping, flooding and aversive conditioning

Other T/T modalities – ECT, Psychosurgery [Cingulotomy, capsulotomy – Caudate tractotomy]

Prognosis:

Acute Onset – 50%. 20-30% Significant improvement, 40-50% moderate, rest may so deterioration

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