treatment for compulsive lying in adults

Compulsions occur in these patients, mostly in presence of cerebral dysfunction and in the absence of obvious 'ego-dystonic' qualities that normally lead adults to report their behaviours’ as excessive or absurd. In patients with intellectual disabilities, first encountered symptoms are generally behavioural problems rather than anxiety. OCD in patients with mental retardation presents with a diagnostic and therapeutic challenge. An OCD also occurs as behavioural phenotypes of specific disorders in persons with mental retardation as Down’s syndrome and Prader-Willi syndrome. Obsessive compulsive disorders (OCD) are known to occur in patients with intellectual disability and at rates least proportional to the general population but often the developmental disabilities and lack of communication in these patients makes it difficult to diagnose and assess the disorder and hence, goes undetected and untreated. At 3 months follow up visit, significant improvement was reported in his daily functioning. Patient was assessed at 2 weeks interval and it was seen that improvement started at 6 weeks of therapy and after around 10 weeks of therapy, patient was significantly improved. At 4 weeks, follow up when complaints of aggression resolved, Fluoxetine was increased to 40 mg and using differential positive reinforcement, exposure and response prevention was conducted.

Patient’s irritability and aggressive behaviour was very prominent so sodium valproate 600 mg was added in divided doses. At 2 weeks there was minimal improvement but a new complaint of episodic sudden and severe aggressive behaviour came up. He was advised dietary modification and regular exercises. Patient was also sent for medicine consultation for deranged blood sugar levels. Patient was started on capsule Fluoxetine 20 mg daily.

He was found to be very anxious during interview and had obsessions of contamination and had compulsive cleaning and washing rituals.įamily members were given psychoeducation regarding the nature of illness and requirement of treatment. Complete mental status examination was done and Yale-Brown Obsessive Compulsive Scale Symptom Checklist was administered. His blood sugar levels were deranged, fasting was 114 mg/dl and postprandial was 148 mg/dl.Ī structured assessment was conducted and the intelligence quotient by Wechsler Adult Intelligence Scale-Performance Scale (Indian adaptation), was found to be 46 (moderate mental retardation). His complete blood count, liver function tests, kidney function tests, thyroid function tests, urinalysis, were within normal range. The general physical and systemic examination was normal. He had no significant past or family history of psychiatric illness and had no history of substance abuse.Įxamination revealed normal vital functions. When stopped from washing hands repeatedly, he becomes very irritated and gets aggressive and used to calms down when he washes his hands again. A 36-year-old male presented to outpatient Department of Psychiatry in mental retardation clinic with complaints of an insidious onset illness characterized by repetitive acts of washing hands, excessive cleaning, bathing and refusing to touch anything when going out of house.

Treatment for compulsive lying in adults