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When seen by dermatologist she indicated treatment, but also indicated that he should be seen by psychiatrist and psychologist for improvement.

by | Nov 12, 2022 | Psychology

 

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Activities to perform:
Perform the case analysis in which you include the description of the symptomatology presented by the patient, the clinical impression, clinical-pathological correlations, as well as the classification of the disorder within the spectrum of O-C disorder (obsessive-compulsive).
Case Study
Male patient, 28 years old, single, Catholic, works as a forensic necropsy technician, lives alone, criminology student.
Motive to consult:
Lesions on his hands from constant washing, associated with thoughts of contamination of more or less 1 year and a half of evolution.
History of the disease:
Patient refers that he has always been very careful with his hygiene and cleanliness, in fact since he was young he changes his clothes and shoes 3 or 4 times a day to be able to feel that he is clean, he does not eat anything that he does not prepare and if for some reason when he is preparing it his hands or the food products he uses pink or touch something different from his containers he discards the product, In his work he is very careful with it, however with the pandemic these situations were becoming more frequent and necessary for him to the extent that during his work procedures he changes his gloves or equipment 3 or 4 times to feel comfortable, In each change he also washes his hands several times, so that since a year ago his hands began to be more red and irritated with some inflammation and pruritus (itching) to see them like that the thoughts of contamination were greater, making it take much longer than before to perform his work, besides that the change of clothes is still like that, He has discarded several pairs of shoes in good condition because he considers that they are contaminated, he lives alone so that he does not risk contaminating his things, at work he has been made comments about his peculiar acts of washing and the appearance of his hands so he was referred to dermatology for attention. When seen by dermatologist she indicated treatment, but also indicated that he should be seen by psychiatrist and psychologist for improvement.
Background:
Medical: only his current dermatological condition.
Allergic: no reference
Surgical: not reported
Traumatic: not reported
Family: hypertensive parents and diabetic maternal aunts and uncles.
Psychiatric: no self-referral. At the family level, he refers that his father is very strict and too punctual since he does not like things to happen out of schedule and if he is late he gets very irritated and despairs easily. His brother is very skilled with numbers, he is an accountant and very methodical, sometimes he does his homework 2 or 3 times, even if it is right from the beginning. His sister has had problems because of her weight as she has become overweight and resorted to cosmetic operations.
Mental examination:
Patient who enters by his own means, alert, adequate gait, language tone and appropriate flow, coherent and congruent in his speech, shy, sad, worried, thought content with ideas in relation to not being able to stop doing the hand washing because the concern about contamination is much, uncontrollable, even knowing that it is exaggerated, ideas also of the dysfunctionality that has generated this in his work, no ideas of death or suicidal or homicidal. Partial insight.

 

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