American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) outlines several psychological conditions. According to American Psychiatric Association (APA, 2013), three primary disorders that comprise the DSM-5 are sleep-wake, eating, and personality disorders. Implementing several treatment approaches has helped people with mental health conditions suffering from various DSM 5 diagnoses. Generally, the specific diagnosis under each component dictates the best approach to the intervention.
Treatment for Feeding and Eating Disorders
A feeding disorder is caused by a chronic disruption of eating or related behavior that results in changed food intake or absorption. Psychotherapy is the first-line treatment for all eating disorders. Depending on the symptoms, a patient treated will either be in a partial or complete hospital program. Trans-diagnostic Cognitive Behaviour Therapy – Enhanced (CBT-E) is an example of psychological therapy used in first-line treatment for all eating disorders. Essentially, it aims to reduce the symptoms and other outcomes and comprises 40 sessions. Maudsley Anorexia Nervosa Therapy for Adults (MANTRA), Specialist Supportive Clinical Management (SSCM) and Focal Psychodynamic Therapy (FPT) are additional psychological therapy for anorexia nervosa treatment (De Jong et al., 2018). All four therapies provide psychological education with a significant aim of restoring the patient’s physical health through weight monitoring, nutritional counseling and meal planning. Generally, these findings can help psychiatric nurse practitioners (PNP) assist patients with eating disorders to develop more effective and healthier habits.
Treatment for Sleep and Wake Disorder
Pharmacotherapy is widely applied as a suitable therapeutic intervention for sleep disorders. According to APA (2013), “sleep disorders are often accompanied by depression, anxiety, and cognitive changes that must be addressed in treatment planning and management” (p. 361). For instance, sleep problems are common post-traumatic stress disorder (PTSD) symptoms. Due to their numerous side effects, antidepressants, benzodiazepines, and non-benzodiazepines were ineffective in treating sleep disorders in PSTD. On the other hand, treatment with prazosin and mianserin was effective; for example, the drug mianserin benefits patients suffering from sleep disorders (Sandahl, 2021). Psychotherapy approaches like Cognitive Behavioural Therapy for Insomnia (CBT-I) and Imaginary Rehearsal Therapy (IRT) are the primary treatment for sleep disorders. IRT focuses on using a non-disturbing dream to replace any nightmares that a patient may be experiencing (Sandahl, 2021). Patients receiving IRT therapies have generally demonstrated good sleep longevity and quality.
Integrative medicine treatment for a sleep disorder is commonly applied where the risk of differential diagnosis and comorbidity is high. Complementary and alternative medicine for insomnia treatment includes acupuncture, melatonin, meditation, yoga, and massage. Most patients preferred melatonin, which is a biological-based therapy. Melatonin is a hormone that originates from the pineal gland and works by regulating the sleep-walk cycle. Overall, melatonin significantly impacts the management of sleep disturbances in adults. Mindful meditation is a form of meditation used in the cases of insomnia. Essentially, it works mainly by reducing stress, leading to improved sleep. As a psychiatric nurse practitioner, these findings can help design a treatment plan depending on the proven clinical effectiveness.
Treatment for Personality Disorder
The treatment of personality disorder varies depending on the patient’s personality disorder’s severity. Psychotherapy treatment includes dialectical behavior therapy and cognitive behavioral therapy. Dialectical behavior therapy consists of team and single-person conversations in which patients get educated on coping with stress and enhancing their interpersonal interactions (“Personality disorders and their treatment,” 2018). Cognitive behavioral therapy, on the other hand, enlightens patients on how to think positively and deal with daily challenges.
Pharmacotherapy treatment using certain drugs has been found to reduce the symptoms of personality disorders in mentally ill patients. The recommended medications include antidepressants, mood stabilizers, anti-anxiety, and antipsychotic drugs (“Personality disorders and their treatment,” 2018). Psychiatric nurse practitioners should be patient when dealing with individuals with personality disorders. Most people with these conditions believe they are normal and may find it insulting when told they have personality disorders. As a result, these findings can help a PNP decide whether to apply psychotherapy or pharmacotherapy depending on the differential diagnosis and associated comorbidity.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Publishing. Web.
De Jong, M., Schoorl, M., & Hoek, H. W. (2018). Enhanced cognitive behavioural therapy for patients with eating disorders: A systematic review. PubMed Central (PMC). Web.
Personality disorders and their treatment. (2018). GradesFixer. Web.
Sandahl, H. (2021). Sleep and PTSD in trauma-affected refugees: Sleep disturbances as a potential target to enhance treatment outcome [Doctoral dissertation]. Web.