A nurse is educating a group of nursing students about the differential diagnosis of obsessive-compulsive disorders (OCDs) in comparison to other mental disorders. Which factor helps differentiate OCDs from other mental disorders?

Choice C rationale:

Risperidone is an atypical antipsychotic medication that is sometimes used as an augmentation strategy in treating OCD, particularly in cases where there are prominent obsessive-compulsive symptoms that are not well-controlled by other interventions. However, it's important to note that risperidone's use in OCD is off-label, meaning it's not approved by regulatory agencies specifically for OCD treatment.

Choice D rationale:

Selective serotonin reuptake inhibitors (SSRIs) are a cornerstone of pharmacological treatment for OCD. These medications, such as fluoxetine, sertraline, and fluvoxamine, increase the availability of serotonin in the brain and help alleviate obsessive-compulsive symptoms. They have been extensively studied and are considered first-line treatment options.

Choice A rationale:

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat depression and anxiety disorders. While it may have some benefit for anxiety symptoms, including those related to OCD, it is not considered a first-line treatment for OCD. SSRIs have shown greater efficacy for OCD management.

Choice B rationale:

Tricyclic antidepressants (TCAs) were among the first medications used to treat OCD. However, their side effect profiles and the availability of more effective and better-tolerated options, such as SSRIs, have led to TCAs being used less frequently for OCD treatment.

Choice E rationale:

Dopamine agonists are not commonly used for OCD treatment. In fact, they can potentially exacerbate symptoms, as imbalances in dopamine transmission are implicated in the pathophysiology of OCD. Using dopamine agonists without a clear rationale could worsen the condition.

Choice A rationale:

Telling the client "It's okay, you don't have to wash your hands" might invalidate the client's feelings and fears, leading to increased anxiety. The client's compulsion to wash their hands is driven by their obsessive thoughts, and dismissing this behavior can be counterproductive.

Choice B rationale:

The correct response acknowledges the client's anxiety and opens a conversation about their feelings. This approach helps build a therapeutic relationship and provides an opportunity for the client to express their concerns. It's essential to address the underlying anxieties associated with OCD to promote better coping strategies.

Choice C rationale:

Telling the client to "calm down and stop thinking about washing your hands" oversimplifies the situation. People with OCD often struggle with controlling their obsessive thoughts and compulsions, and such a directive can be ineffective and frustrating for the client.

Choice D rationale:

Offering to "help you wash your hands" reinforces the client's compulsion rather than addressing the root cause of their anxiety. Enabling their compulsive behavior can contribute to the maintenance of their OCD symptoms.