1- Read the Case Study of Marvin. In addition to anxiety being a symptom of ment

1- Read the Case Study of Marvin.
In addition to anxiety being a symptom of mental health diagnoses, it can also be a symptom of certain medical illnesses.
Find a medical condition that can mimic or cause anxiety and obsessive-compulsive symptoms, and find two articles about that medical disorder.
Post your summary of the two research articles you reviewed. Be sure that you integrate both into one coherent summary, providing support for your claims about which medical conditions should be kept in mind when seeing anxiety and obsessive-compulsive symptoms.
What, if any, ethnic or cultural controversies are factors to consider when teasing out the etiology of anxiety and obsessive-compulsions related to this medical concern?
Note: You may want to pay particular attention to the sections of your DSM-5-TR text that review substance or medication-induced anxiety or obsessive-compulsive disorders, as well as possible medical reasons for the disorders.
Any of the listed medical conditions might contribute to Marvin’s anxiety and obsessive-compulsive behaviors.
Provide a critical evaluation of the research you studied.
Is it methodologically robust?
Are the findings sufficiently robust to persuade you?
Be sure to support your conclusions well. Think about these issues carefully before you begin to write this post. It will be particularly important for you to answer these questions:
How do you know the research is methodologically robust?
What is needed to make it robust?
If you are unsure about this, how can you get your questions answered?
Read the Case Study Response Guide to assist you with this discussion.
2-Week 3 Discussion 2: Case Study of Marvin
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Review the Case Study of Marvin. Using the medical illness you choose to write about in this week’s first discussion, respond to the following:
How would this specific medical condition or illness be likely to impact or interact with Marvin’s described anxiety symptoms and obsessive-compulsive symptoms?
How would you sort out (understand) the differential impacts of the two conditions (obsessive-compulsive disorder, as opposed to the medical condition you chose)?
Would you still make a diagnosis of obsessive-compulsive disorder if you found that Marvin also suffered from this disorder?
How do you differentiate Marvin’s obsessive-compulsive symptoms between the related diagnoses of:
Obsessive-compulsive disorder.
Obsessive-compulsive personality disorder.
Defend your answer.
Record the diagnosis you would give Marvin if he clearly displays this medical condition in addition to his anxiety and obsessive-compulsive symptoms. Review the Case Study Response Guide to assist you with this discussion.
3-Review the other posts of other learners, and respond to them. What did you learn from their research and writing? Do you agree with their diagnosis? Why or why not? Explain your position.
3.1Isabelle Kofflin
Oct 21, 2023Oct 21 at 3:03pm
Hyperthyroidism is a condition that causes the thyroid to make too much of a hormone and in turn, can cause nervousness, restlessness, and an accelerated heart rate (De Leo et al.; 2016). The most common cause for hyperthyroidism is Graves’ Disease. Graves’ Disease causes the thyroid to be enlarged and is an autoimmune disease that does not have much research for treatment. Beta blockers are known to be one of the most viable ways to treat this, and if a person develops hyperthyroidism during or after pregnancy, it requires special assessment and may require different treatment. Unfortunately, those with hyperthyroidism do not have improved quality of life, even given the research into the disorder(He et al.; 2022). There is a very high need to treat this disorder, so research and therapeutic ideas are very necessary to consider treating this disorder.
It is always important to consider the physical and cultural pieces of anxiety in disorders, there is a chance that a person is experiencing a very physical experience that does not need to be treated with talk therapy, but rather medication. If a patient like Marvin were experiencing restlessness because his body is physically not processing properly, it would be essential that his thyroid would be treated. It would be essential that Marivn be provided medication for his thyroid as well as medication to help with compulsive thoughts. In terms of Marvin’s diagnosis, Marvin could possibly have hyperthyroidism, given the nervousness and restlessness with washing excessively, but I really can’t see it being the only reason for Marvin’s symptoms. I can really see it being a big factor of his symptoms, but not the only reason.
As far as culture goes, it is essential to make sure that assessment for a patient is done in their native language and that culture is taken into consideration when assessing someone. An example would be that different cultures show anxiety differently. In Somali culture, people will complain of headaches and stomachs rather than complaining of anxiety and fear. How anxiety manifests should always be considered when considering diagnoses.

De Leo, S., Lee, S. Y., & Braverman, L. E. (2016). Hyperthyroidism. The Lancet,
388(10047), 906-918. https://doi.org/10.1016/S0140-6736(16)00278-6
He, Q., Dong, H., Gong, M., Guo, Y., Xia, Q., Gong, J., & Lu, F. (2022). New
Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on
Immunology and Ingredients From Traditional Chinese Medicine. Frontiers in pharmacology, 13, 862831. https://doi.org/10.3389/fphar.2022.862831Links to an external site.
3.2Isabelle Kofflin
Oct 21, 2023Oct 21 at 3:03pm
Hyperthyroidism is a condition that causes the thyroid to make too much of a hormone and in turn, can cause nervousness, restlessness, and an accelerated heart rate (De Leo et al.; 2016). The most common cause for hyperthyroidism is Graves’ Disease. Graves’ Disease causes the thyroid to be enlarged and is an autoimmune disease that does not have much research for treatment. Beta blockers are known to be one of the most viable ways to treat this, and if a person develops hyperthyroidism during or after pregnancy, it requires special assessment and may require different treatment. Unfortunately, those with hyperthyroidism do not have improved quality of life, even given the research into the disorder(He et al.; 2022). There is a very high need to treat this disorder, so research and therapeutic ideas are very necessary to consider treating this disorder.
It is always important to consider the physical and cultural pieces of anxiety in disorders, there is a chance that a person is experiencing a very physical experience that does not need to be treated with talk therapy, but rather medication. If a patient like Marvin were experiencing restlessness because his body is physically not processing properly, it would be essential that his thyroid would be treated. It would be essential that Marivn be provided medication for his thyroid as well as medication to help with compulsive thoughts. In terms of Marvin’s diagnosis, Marvin could possibly have hyperthyroidism, given the nervousness and restlessness with washing excessively, but I really can’t see it being the only reason for Marvin’s symptoms. I can really see it being a big factor of his symptoms, but not the only reason.
As far as culture goes, it is essential to make sure that assessment for a patient is done in their native language and that culture is taken into consideration when assessing someone. An example would be that different cultures show anxiety differently. In Somali culture, people will complain of headaches and stomachs rather than complaining of anxiety and fear. How anxiety manifests should always be considered when considering diagnoses.

De Leo, S., Lee, S. Y., & Braverman, L. E. (2016). Hyperthyroidism. The Lancet,
388(10047), 906-918. https://doi.org/10.1016/S0140-6736(16)00278-6
He, Q., Dong, H., Gong, M., Guo, Y., Xia, Q., Gong, J., & Lu, F. (2022). New
Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on
Immunology and Ingredients From Traditional Chinese Medicine. Frontiers in pharmacology, 13, 862831. https://doi.org/10.3389/fphar.2022.862831Links to an external site.
3.3Isabelle Kofflin
Oct 22, 2023Oct 22 at 10:20am
Given that hyperthyroidism is a consideration in Marvin’s diagnosis, it would explain the general restlessness, nervousness, and high heart rate that he could potentially be experiencing. That would greatly impact how he is feeling and be a very good explanation for some of the behaviors he is having. Restlessness could result in excessive washing, needing things to be a certain way, and the feeling of guilt for being a “house husband”. Not allowing his kids to have friends over and the fear of touching certain substances could be fear based and the anticipation and nervousness could result from him having a medical condition that works up his body.
According to the DSM 5TR, obsessive compulsive disorder is described as the presence of obsessions, compulsions, or both that are time consuming and cause distress not attributed to another medical condition or substance. It is also important . Marvin seems to have fair insight to his delusions, as he is coming to be evaluated on his own accord and understands that his delusions are not based in reality (2023). According to the Cleveland Clinic, to diagnose hyperthyroidism, a physical exam, blood test for thyroid levels, and an imaging test are necessary (2023). This would be able to be accomplished in a simple doctor’s appointment, where a blood test could be included. How these two disorders are tested are very different and could be assessed and compared to find an effective prognosis.
I would still diagnose Marvin with at least an anxiety disorder or phobia regardless of if he had hyperthyroidism. Though I agree that there are lots of symptoms of his that coincide with hyperthyroidism, I do think that the aspect of specific sensory things as being “dirty” to Marvin, there is another piece of the puzzle that is not being inspected. The fact that these revolve around kids and schools really does interest me. I wonder what inspired this phobia of things related to them.
Obsessive-compulsive disorder is characterized by recurrent or persistent thoughts that the patient attempts to control with an action or repress, repetitive behaviors, or actions aimed at preventing an imagined catastrophic event. These actions are time-consuming and are not attributed to any substances or other mental health disorder. This is an involuntary reaction to thoughts that a person has that causes anxiety in an attempt to stop something catastrophic from happening. Obsessive-compulsive personality disorder is described as being preoccupied with details, rules, and lists, perfectionism that impedes on the task at hand, being excessively dedicated to work to the point that leisurely activity is not possible, being overly conscious of morality, ethics, and values, being unable to discard items that are no longer useful, being reluctant to relegate tasks to others, saves money for the event of a catastrophe, and showing rigidity and stubbornness. To me, this would be called a “type A personality”, or someone who is very rigid, does not like to accept help, and works to the point that they struggle to maintain social interactions (American Psychology Association; 2023).
I would diagnose Marvin with obsessive compulsive disorder, I feel that diagnosis suits him best given his symptoms. I would like to have him tested for potential hyperthyroidism to be able to factor that out as I feel he could potentially be experiencing some symptoms because of this.
Works Cited
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders
(5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787Links to an
external site.
professional, C. C. medical. (n.d.). Hyperthyroidism: Symptoms, causes, treatment &
medication. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/14129-hyperthyroidism
3.4Raswinder Nagra
MondayOct 23 at 3:56pm
Obstructive sleep apnea can interact with Marvin’s described anxiety symptoms as studies by Lee et al. (2015) notes that 48.8 % of patients with OSA have anxiety. This is noted as Lee et al. (2015) shares that the prevalence of anxiety is between 11 – 17% in unselected OSA patients and 50 – 70% in selected OSA patients. Research notes that comorbid anxiety may be related to OSA as mood and affect can be due to neural injuries and this is supported by MRI studies that note brain abnormalities in anxious OSA patients, with changes in the cortex, thalamus, hippocampus, and amygdala. Based on this research, it would be important to rule out OSA, as the underlying risks of health-related comorbidities could arise with OSA, such as anxiety, depression, hypertension, and cardiovascular disease.
Obsessive-compulsive disorder presents differently from anxiety caused by OSA as the DSM-5-TR notes that OCD is characterized by obsessions such as recurrent thoughts or urges and compulsions such as repetitive behavior or mental acts in accordance to rigid rules (American Psychiatric Association, 2022). OSA presents with more anxiety, depression, high BMI, daytime sleepiness, and difficulty concentrating (Lee et al., 2015). Accordingly, I would still make a diagnosis of OCD if Marvin also had OSA, as Marvin has contamination obsessions such as avoidance of touching library books or anything that is sticky or handling cigarettes or cigarette logos and cleaning compulsions such as the need to wash his clothes upon entering the house. The level of impairment is severe as Marvin is unable to have friends over and maintain employment.
Marvin’s obsessive-compulsive symptoms can be differentiated into the related diagnoses of obsessive-compulsive disorder as he presents with obsessions such as recurrent and persistent urges and he attempts to address his contamination urges by mental acts such as saying mantras or cleaning behaviors of washing clothes immediately upon entering the home. The obsessive-compulsive symptoms are not related to the use of a drug and I can not determine a better mental disorder to determine the cause of his symptoms. These symptoms also cause clinically significant distress by feeling guilt and shame and fear of his wife leaving him with social and occupational impairements. It is noted that the mean age of this is 19.5 which correlated with his start to psychotherapy since the age of 18, indicating Marvin was seeking help.

Obsessive-compulsive personality disorder is defined as a “pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency” (American Psychiatric Association, 2022). This is noted as there would be indicated by at least a minimum of four of the following: preoccupation with rules, or schedules, perfectionism interfering with completing tasks, high devotion to work with no leisure activities and friendships, inflexibility with morality or ethics, unable to discard worthless objects, reluctance with delegation, miserly spending style, and stubbornness (American Psychiatric Association, 2022). I would not use this as a primary diagnosis as Marvin is more apt to be driven by cleaning obsessions and washing compulsions. A more thorough case history could be employed to determine how he engages with tasks and activities with his wife and children. Interviewing them may also bring clarity to the issue, as they may think this stubborn adherence to perfection and control is most important.
The diagnosis I would give Marvin would be
(F42.2) Major Obsessive Disorder with fair insight
Other Factors
Obstructive Sleep Apnea
Z63.0 Relationship Distress with Spouse
Z56.9 Other Problems related to Employment; this is chosen as Marvin as a house husband, but it is unclear if he could work outside of the home consistently
References ( Please note hanging indent not available)
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787Links to an external site.
Lee, S., Han, S., & Ryu, H. U. (2015). Anxiety and its relationship to quality of life independent of depression in patients with obstructive sleep apnea. Journal of Psychosomatic Research, 79(1), 32-36. https://doi.org/10.1016/j.jpsychores.2015.01.012