Obsessive compulsive disorder (OCD) Quiz: Ace Your Exams
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A 45-year-old nonbinary person presents to the psychiatry office because of intrusive thoughts and compulsive handwashing for the past two years. The patient is currently taking fluvoxamine but has not experienced significant improvement in symptoms or changes in their Yale-Brown obsessive-compulsive score (Y-BOCS). A previous trial with fluoxetine provided minimal benefit. In addition to pharmacotherapy, the patient participates in exposure and response prevention therapy (ERP), which has provided only mild benefit. There is no significant medical history or other psychiatric history. Temperature is 37.0°C (98.6°F), pulse is 84/min, respirations are 15/min, and blood pressure is 135/85 mmHg. Cardiopulmonary examination is normal. The mental status exam reveals an anxious-appearing adult with meticulous grooming and hygiene. Laboratory studies, including a complete blood count and complete metabolic panel, are within normal limits, and a urinary drug screen is negative. Which of the following is the most appropriate next step in patient care?
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