Avoid seeking advice from multiple doctors or emergency . Hypochondriasis. Desired Outcome: The patient will be able to cope with her current condition by re-establishing normal ADLs. 258(19):2718-22. ((Tammy J. Toney-Butler and Jennifer M. Thayer, Nursing Process, StatsPearls, July 10, 2020: https://www.ncbi.nlm.nih.gov/books/NBK499937/)). The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Shayna L Marks, BA, MA; Dandan Liu, BA; and Celia Chang, MD to the development and writing of this article. This can affect the affected persons occupational and social functioning, as well as activities of daily living. A nursing diagnosis is based on Maslows Hierarchy of Needs pyramid ((Saul McLeod, Maslows Hierarchy of Needs, Simply Psychology, Dec. 29, 2020: https://www.simplypsychology.org/maslow.html)) (which identifies and ranks human needs) and helps prioritize treatments. James A Bourgeois, MD, OD, MPA Chair, Department of Psychiatry, Baylor Scott and White Health, Central Texas Division; Clinical Professor, Department of Medical Education, Texas A&M University Health Science Center College of Medicine Response and Remission After Cognitive and Exposure Therapy for Hypochondriasis. Illness anxiety disorder is a chronic mental illness previously known as hypochondria. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. 0000114297 00000 n PTSD is classified under Anxiety Disorders. The symptoms are mostly more severe than that experienced by a distressed person without somatoform disorder. ((Tammy J. Toney-Butler and Jennifer M. Thayer, Nursing Process, StatsPearls, July 10, 2020: can gather data about the patients vital signs, physical complaints, visible body conditions, medical history, and current neurological functioning. 0000005100 00000 n The documentation format will vary according to. Looper KJ, Kirmayer LJ. Lidbeck J. She also specialized in these areas: ER, Orthopedic Ward and the DR. 1999 Aug. 60(8):554. Someone with illness anxiety disorder generally fits into one of these categories: Someone with somatic symptom disorder may obsess and worry about their health just like someone with illness anxiety disorder. 2012 Mar-Apr. Psychother Psychosom. Olatunji BO, Kauffman BY, Meltzer S, Davis ML, Smits JA, Powers MB. J Behav Ther Exp Psychiatry. It leads to persistent contraction and malabsorption of the colon, producing frequent bowel movements. Illness anxiety disorder also puts you at risk for: Your healthcare provider may partner with a mental health professional, such as a psychologist or psychiatrist, to help you manage the disorder. 0000003184 00000 n Kellner R, Abbott P, Pathak D, Winslow WW, Umland BE. Should I look out for signs of complications? Factors that maintain anxiety in patients with hypochondriasis. Allow for time-limited structured discussions about somatic concerns. Hypochondriasis. ((Tammy J. Toney-Butler and Jennifer M. Thayer, Nursing Process, StatsPearls, July 10, 2020: : Your goals for the patient must be well-defined and unambiguous. It is a type of somatoform disorder that affects the person for a long time, with symptoms related to. Illness anxiety disorder can affect all ages and genders. 0000003573 00000 n ((Mariam Yazdi, 4 Steps to Writing a Nursing Care Plan, Nurse.org, March 23, 2018: https://nurse.org/articles/nursing-care-plan-how-to/)) A nursing care plan should include: Successful care plans use the fundamental principles of critical thinking, client-centered techniques, goal-oriented strategies, evidence-based practice (EBP) recommendations, and nursing intuition. Care plans also provide a means of communication among nurses, their patients, and other healthcare providers to achieve health care outcomes. [QxMD MEDLINE Link]. 70(3):810-27. Psychol Med. Work with your medical care provider and mental health professional to determine a regular schedule for visits to discuss your concerns and build a trusting relationship. 1996 Jan. 34(1):23-31. 2007. Diagnosis is based on history, medical complaints, the doctors physical assessment and laboratory tests performed. [QxMD MEDLINE Link]. Bass C, ed. DOI: 10.1002/14651858.CD006520.pub2. BMC Psychiatry. ((TigerConnect, How to Develop a Nursing Care Plan for Your Hospital: Care plans also need to be easy to share with the relevant stakeholderspatients, doctors, other members of the nursing team, insurance companies, etc. Somatic Symptom Disorder and Illness Anxiety Disorder. Treatment of hypochondriasis with clomipramine. Sometimes a patient should be assigned to a nurse with specific skills and experience; a care plan makes that process easier. Nursing Care Plans, 10th Edition - 9780323711180 - Elsevier Several authors have suggested a cognitive-educational approach to understand the development of the severe anxiety associated withillness anxiety disorderand the factors that maintain the long-term anxiety. 2011 Jun. 2010 Nov 26. Somatoform disorder can lead to the following: The goal of treatment for a patient with somatoform disorder is to improve quality of life and help the person function. 0000113110 00000 n [QxMD MEDLINE Link]. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it?. Aerobic, Breathing Exercises Tied to Faster Concussion Recovery, Prepare for Endometriosis Excision Surgery With a Multidisciplinary Approach, TMS Tied to 'Marked' Antidepressant, Anxiolytic Effects in Anxious Depression. 135(6):609-14. ((Nursco, Professionalism in Nursing 5 Tips for Nurses, July 13, 2018: The University of St. Augustine for Health Sciences (USAHS) offers a, designed for working nurses. 6:638-45. Sometimes, when they develop a real medical illness, they wont get proper care and effective treatment because of their search of confirmation to their believed condition. Writing skills are crucially important for nursesyoull need to be as accurate and current as possible in your descriptions. [QxMD MEDLINE Link]. Appointments 866.588.2264 Appointments & Locations Request an Appointment Because no doctor can give them the precise medical result of their assumed disease, hypochondriasis clients have the tendency to go from one doctor to the other. Ravindran AV, da Silva TL, Ravindran LN, Richter MA, Rector NA. Gottlieb GL. Heres what a care plan written by a student looks like: Note that student care plans often have an additional columnrationalewhere students note the scientific explanation for the implementations they chose. Compr Psychiatry. J Consult Clin Psychol. 18 Heart Failure Nursing Care Plans - Nurseslabs McManus F, Surawy C, Muse K, Vazquez-Montes M, Williams JM. ((Tammy J. Toney-Butler and Jennifer M. Thayer, Nursing Process, StatsPearls, July 10, 2020: https://www.ncbi.nlm.nih.gov/books/NBK499937/)). 0000004588 00000 n However, it is believed that the following risk factors contribute to how a person responds to symptoms and how they are perceived: The symptoms experienced that a person with somatoform disorder is often more severe than usual. On the other hand, nurses often assume some basic concepts and note some of the steps in the care plan only mentally. Illness Anxiety Disorder (formerly Hypochondriasis), encoded search term (Illness Anxiety Disorder (formerly Hypochondriasis)) and Illness Anxiety Disorder (formerly Hypochondriasis), Pediatric Illness Anxiety Disorder (Formerly Hypochondriasis), Psychiatric Disorders Associated With Epilepsy, Fast Five Quiz: Generalized Anxiety Disorder. The treatment of hypochondriasis: exposure plus response prevention vs cognitive therapy. [ c0@ALJp6HZ&dA\G\ES 4Bc !HH?bqj{nm%v]2le 4q-7K'KK3K=e g_`U(jWcNd8x!#x$Y$op^JbairHOa# A care plan is your roadmap for effective nursing care, and a collaboration tool that improves the entire healthcare process. [39] Randomized controlled trials now suggest that cognitive-behavioral therapy (CBT) is efficacious in the treatment of illness anxiety disorder Last reviewed by a Cleveland Clinic medical professional on 02/02/2021. Somatic Symptom and Related Disorders. 1982 Apr. 66(5):363-77. A Master of Science in Nursing, Whether youre an aspiring healthcare provider or a seasoned nurse practitioner, you may have considered pursuing a Master of Science in Nursing (MSN). They also enable. Therefore, while such treatments may be indicated at some time (in the future), prematurely offering a diagnosis or psychiatric treatment may, in fact, impair the establishment of a trusting patient-physician relationship. No. The client will follow an established daily routine. As an Amazon Associate I earn from qualifying purchases. [QxMD MEDLINE Link]. Promote behavior modification by acknowledging the patients efforts to positively cope with his/her current condition, as well as giving more attention and time discussing positive changes in his/her symptoms. General Nursing Care Plans - Nurseslabs Patients with illness anxiety disorder should eat 3 meals per day to feel as healthy as possible. Its also a tool for them to think critically and holistically in a way that supports the patients physical, psychological, social, and spiritual care. Psychol Med. Some people with illness anxiety disorder may actually have a diagnosed physical illness. A symptom of somatoform disorder can indicate a particular condition like cancer. The purpose of a nursing care plan is to document the patients needs and wants, as well as the nursing interventions (or implementations) planned to meet these needs. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. The Nurse's Guide to Writing a Care Plan | USAHS - University of St The student version is much longer, has a greater level of detail, and is exhaustively thorough. St. Louis, MO: Elsevier. Fallon BA, Liebowitz MR, Salman E, Schneier FR, Jusino C, Hollander E. Fluoxetine for hypochondriacal patients without major depression. diagnosis care plan format includes a definition/explanation of the diagnosis, related factors, defining characteristics, expected outcomes, related NOC Outcomes and NIC Interventions, ongoing assessment, and therapeutic interventions.Disorders care plan format covers synonyms for the disorder (for ease in cross referencing), a definition, [38]. Hollifield M, Tuttle L, Paine S, Kellner R. Hypochondriasis and somatization related to personality and attitudes toward self. In addition, the goal of the treatment is also targeted to change the thinking and behavior of the individual that leads to the symptoms. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. A person who has PTSD will experience flashbacks of a traumatic event that a person has experienced or witnessed which is serious enough causing him or her impairment in his or her ability to function as a person. These strategies may prevent potentially serious complications, including the effects of unnecessary diagnostic and therapeutic procedures. Nursing care plans help define nursing guidelines and some treatment guidelines (as ordered) for a specific patient. You are being redirected to Nursing Care Plan for Elderly in the Community 5. 0000002815 00000 n Illness anxiety disorder is a chronic mental illness previously known as hypochondria. Genetic and biological factors. Spend sufficient time on health care maintenance issues such as diet, experience, smoking cessation, and cancer detection. It can help improve social situations and build relationships. J Anxiety Disord. Nursing Diagnosis: Ineffective Coping related to somatoform disorder as evidenced by restlessness, failure to do activities of daily living as normal, verbalization of distress. 2000 Aug. 2(4):117-121. The symptoms of hypochondriasis are the following: Diagnosing hypochondriasis can be difficult since clients with this disorder are convinced that their symptoms are caused by a medical illness. Lippincott's manual of psychiatric nursing care plans Assessment and management of patients referred for a psychiatric opinion. Formal psychometric testing may be of help. ((TigerConnect, How to Develop a Nursing Care Plan for Your Hospital: Despite the overall general objective, nursing care plans written by students are not the same as those created by. Treat comorbid psychiatric disorders concurrently. In such a case, an illness anxiety disorderdiagnosis may be established in the context of an inpatient admission. When no physical cause for their symptoms can be found, clients often become upset and experience even more symptoms, or the symptoms may change. 1982. Somatic symptom disorder - Diagnosis and treatment - Mayo Clinic - Mayo 2003 Jun. The symptoms related to somatoform disorder may vary and can range from mild to severe. People with this disorder have a persistent fear that they have a serious or life-threatening illness despite few or no symptoms. J Clin Psychiatry. It affects about 0.1% of Americans. : The patients goals should have a clear starting time and end date (which can be flexible). Treatment of underlying conditions. 0000107836 00000 n 2007 Jan. 164(1):91-9. Atmaca M, Korkmaz H, Korkmaz S. P wave dispersion in patients with hypochondriasis. 39(4):423-42. : Why does your patient suffer from this? She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. Post-Professional Doctor of Occupational Therapy (PPOTD), Master of Science in Physician Assistant Studies (MSPAS), Orthopaedic Manual Physical Therapy Fellowship (OMPT), Non-Degree Physical Therapy Online Courses, Master of Science in Speech-Language Pathology (MS-SLP), How to Write a Care Plan: A Guide for Nurses, https://nurseslabs.com/nursing-care-plans/, https://medical-dictionary.thefreedictionary.com/nursing+care+plan, https://www.healthnavigator.org.nz/clinicians/c/care-planning/, https://www.ncbi.nlm.nih.gov/books/NBK499937/, https://qualitysafety.bmj.com/content/qhc/9/1/6.full.pdf, https://nanda.org/publications-resources/resources/glossary-of-terms/, https://www.simplypsychology.org/maslow.html, https://pubmed.ncbi.nlm.nih.gov/29777561/, https://nurse.org/articles/nursing-care-plan-how-to/, https://tigerconnect.com/blog/how-to-develop-a-nursing-care-plan-for-your-hospital/, https://www.nursco.com/professionalism-nursing-5-tips-nurses/. What is an MSN degree? The MSN has several options to accelerate your time to degree completion. Using the collected data, you will develop a nursing diagnosiswhich the North American Nursing Diagnosis Association (NANDA) defines as a clinical judgment about the human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group or community. ((NANDA, Glossary of Terms: https://nanda.org/publications-resources/resources/glossary-of-terms/)), A nursing diagnosis sets the basis for choosing nursing actions to achieve specific outcomes. Debra Kahn, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, American Psychiatric Association, Association of Women Psychiatrists, California Psychiatric Association, Central California Psychiatric SocietyDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Otsuka Pharmaceutical Development & Commercialization, Inc. Glen L Xiong, MD Associate Clinical Professor, Department of Psychiatry and Behavioral Sciences, Department of Internal Medicine, University of California, Davis, School of Medicine; Medical Director, Sacramento County Mental Health Treatment Center In clinical settings, both the availability of CBT and treatment adherence of patients with illness anxiety disorder to psychotherapy in general are major barriers to successful outcomes. Resource utilization of patients with hypochondriacal health anxiety and somatization. 1987 Nov 20. Psychosomatics. Symptoms range from nightmares to thoughts of suicide. Am J Psychiatry. Seeking reassurance from loved ones about your symptoms or health. Xiong GL, Bougeois JA, Chang CH, Liu D, Hilty DM. Am J Psychiatry. 1990 Sep. 76(281):991-6. [QxMD MEDLINE Link]. The following treatment can be combined to manage a person with this condition: Hypochondriasis clients need to live in an understanding and supportive environment. 1992. [QxMD MEDLINE Link]. Fallon BA, Petkova E, Skritskaya N, et al. 2002. Med Care. Couple reassurance statements of normal findings with statements that that the patient will not be abandoned. Pain disorder. J Psychosom Res. Tachycardia is an early sign of heart failure. The MSN has several options to accelerate your time to degree completion. General Nursing Care Plans, Nursing Care Plans, Surgery and Perioperative Care Plans. 0000268920 00000 n Somatoform disorders are psychiatric illnesses characterized by the presence of physical symptoms suggesting medical condition that cannot be explained by an actual physical disorder. You may miss out on time with loved ones because youre concerned about your health. It helps reduce symptoms related to anxiety, depression, and. Pediatrics. Smith, it appears that you are still having concern about having a several medical disorder despite all the workup, which, so far, has not showed any abnormal finding. 1995 Jan. 30(1):44-8. Family therapy can be included in the therapy regimen to assess family relationship and establish family support. It is possible that case management and integrated primary care and psychiatry programs may be especially suitable for patients with illness anxiety disorder and somatic symptom disorder. Even after medical tests show no problems, people with hypochondriasis are still preoccupied with the idea that think theyre seriously sick. This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. Pearce MJ, Mayou RA, Klimes I. 0000004042 00000 n 1991 May-Jun. 0000004746 00000 n Common limbic and frontal-striatal disturbances in patients with obsessive compulsive disorder, panic disorder and hypochondriasis. Anxiety ADVERTISEMENTS Anxiety Media Inquiries: (760) 407-2301 0000106964 00000 n The implementation stage consists of performing the nursing interventions outlined in the care plan. [QxMD MEDLINE Link]. 0000111578 00000 n Nursing care plans are a vital part of the nursing process. J Clin Psychopharmacol. Assessment: 1. Primary care physicians generally treat illness anxiety disorder, with psychiatrists providing consultation. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. As a nurse, you will either follow doctors orders for nursing interventions or develop them yourself using evidence-based practice guidelines. 0000024858 00000 n 1983 Mar. Our degrees are offered online, with optional on-campus immersions. van den Heuvel OA, Mataix-Cols D, Zwitser G, Cath DC, van der Werf YD, Groenewegen HJ, et al. Br J Dermatol. Covering the most common medical-surgical nursing diagnoses and clinical problems, Gulanick & Myers' Nursing Care Plans: Diagnoses, Interventions, and Outcomes, 10th Edition features more than 200 care plans, each reflecting the latest evidence-based guidelines and . Please confirm that you would like to log out of Medscape. , along with important values like accountability, respect, and integrity. The implementation stage consists of performing the. Hypochondriasis Disorder - RN speak Substance use can make symptoms worse. This can improve social interactions and can have an effect on mood as well. Without the nursing care planning process, quality and . Successful treatment with pimozide of delusional parasitosis. Assess the patient's developmental needs. 1989. 1977. a) No physiologic cause has been found for his symptoms. Medscape Education. Be aware of emotional reactions toward the patient (ie, anger, hopelessness, helplessness) and seek frequent informal consultation when possible. Remember that the purpose of a nursing care plan is not to be a static document, but to guide the entire nursing process and enable teamwork, with the goal of improving care. 179(5):279-83. 140(3):273-83. %%EOF Some people become severely depressed and even suicidal. Healthcare experts dont know why some people develop illness anxiety disorder. 0000004998 00000 n Visser S, Bouman TK. 0000000016 00000 n A clinical study. The following lifestyle changes can be helpful in managing somatoform disorder: Good working relationship with care providers. Visser S, Bouman TK. It also helps in reducing stress and preoccupation with health and physical symptoms. [QxMD MEDLINE Link]. You may go through periods where you have little or no health anxiety and then it returns. 11:99. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. 310-318. [QxMD MEDLINE Link]. It's simply a guide that helps your healthcare team consider and address all of your healthcare needs. To establish baseline and ensure that there is no physical rationale for the patients complaint of pain. We do not endorse non-Cleveland Clinic products or services. Geriatric Nursing Diagnosis & Care Plan - NurseStudy.Net 13(2):127-39. Henningsen P, ed. Since most of the symptoms are related to mental and psychological health, treatments often include psychotherapy. Interventions are classified into the following seven domains: family, behavioral, physiological, complex physiological, community, safety, and health system interventions. 0000117833 00000 n Personality disorders in hypochondriasis: prevalence and comparison with two anxiety disorders. Patient goals in a nursing care plan should be obtainable and lead to their recovery. Medications. Tyrer P, Cooper S, Tyrer H, et al. The management of atypical non-cardiac chest pain. This is essential in helping them cope up with the disorder better. [QxMD MEDLINE Link]. Psychol Med. JAMA. 0000107422 00000 n Vera., Nursing Care Plans (NCP): Ultimate Guide and Database, July 5, 2021: : heart rate 100 bpm, dyspnea, restlessness, guarding behavior., : impaired gas exchange RT collection of mucus in airway., : patient must maintain optimal gas exchange., : assess respiration; encourage breathing and position changes., : respiration will indicate the level of lung involvement, as the patient will adjust their breathing to facilitate gas exchange; these will improve ventilation and allow for chest expansion., : the patient maintained good gas exchange, normal respiratory rate., Wrapping Up: Writing an Effective Nursing Care Plan, For example, one of the benefits of writing care plans is that it will allow you to develop. [QxMD MEDLINE Link]. Medications and cognitive behavior therapy (CBT) can help. [QxMD MEDLINE Link]. HlWpdR#I?&'teWkf"-^zqZUcO~|_~xKyIX wH/p]z#yw0.QG`qnq}>hwhhwCeX[/:TdJ]a;1-1%\"MD/LBc/nuKw6h-9oA"99gQ M>Qv$w/,)CB qE4a,vTXdI"yHMk|LznqW`^N =zYJT5mbg\8.P"8smZ3PkKhL:rS&!A Auscultate apical pulse, assess heart rate. Using the collected data, you will develop a nursing diagnosiswhich the North American Nursing Diagnosis Association (NANDA) defines as a clinical judgment about the human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group or community. ((NANDA, Glossary of Terms: A nursing diagnosis sets the basis for choosing nursing actions to achieve specific outcomes. For effective communication, keep in mind the following best practices when writing a care plan: Although you will learn communication skills in an undergraduate or graduate nursing program, you will also develop them over time and with practical experience. In hypochondriasis, the patient can have unrealistic. 1999 Dec. 30(4):251-8. Medications. Medical management and psychiatric treatment. Therapy. The advanced, Nurse practitioners and physician assistants are advanced healthcare practitioners with similar responsibilities, such as diagnosing illnesses and prescribing medications. 0000178746 00000 n [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. 0000002769 00000 n Salkovskis PM, Rimes KA, Warwick HM, Clark DM. 0000309569 00000 n 3:30-40. For patients, having clear goals to achieve will make them more involved in their treatment and recovery. [QxMD MEDLINE Link]. 30(3):301-6. St. Louis, MO: Elsevier. Childhood illness or serious illness in your family during childhood. This causes further emotional distress, hence increasing physical disability. Medical-surgical nursing: Concepts for interprofessional collaborative care. Focus on care of the patient with illness anxiety disorder, not exclusively on a cure for the disorder. 2011 May 13. Establish one primary care physician as the patient's main physician. This national network of local crisis centers provides 24/7 free, confidential support to people in suicidal crisis or emotional distress. [QxMD MEDLINE Link]. b) His symptoms subside with appropriate medical treatment. Lipowski ZJ. Acta Psychiatr Scand. 2012 Nov-Dec. 53(6):566-74. 19(4):327-39. Developing a Nursing Care Plan for Your Hospital | TigerConnect There are several basic interventions that you need to implement during each shift: pain assessment, changing the resting position, listening, cluster care, preventing falls, and fluid consumption. A randomized controlled trial. Psychosomatics. It is important to encourage the patient to verbalize any negative thoughts, feelings, and behaviors in order for the nurse and healthcare team to provide holistic care and keep him/her safe. Mood, cultural, developmental, and environmental factors that influence hypochondriasis. 1-13. Glen L Xiong, MD is a member of the following medical societies: AMDA - The Society for Post-Acute and Long-Term Care Medicine, American College of Physicians, American Psychiatric Association, Central California Psychiatric SocietyDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: SafelyYou, Blue Cross Blue Shield, Included Health
book co-editor for: Wolter Kluwer, American Psychiatric Publishing Inc. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. Your provider can diagnose and treat illness anxiety disorder. Somatoform disorder, also known as Somatic Symptom Disorder (SSD), is a mental health condition characterized by having significant physical symptoms brought about by psychological or emotional distress. A systematic review. That implies checking in with patients frequently and recording data about how the patient is progressing toward their goals, which will be important in the evaluation stage of the care plan. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). [QxMD MEDLINE Link]. 0000235166 00000 n * Role specialties include. : CD006520. But you will continue to receive regular care from your provider. **The Nurse Educator role specialty is not available for the DNP program. 160 0 obj<>stream : Their goal should be possible to achieve. Hollander E, Stein DJ, Decaria CM, Cohen L, Islam M, Frenkel M. Disorders related to OCD--neurobiology.