Question

A 16-year-old girl is brought to the clinic by her mother due to worsening symptoms of Crohn's disease. Upon inquiry, she mentions that she has not been adhering to the medication and lifestyle changes prescribed to her by the doctor. She further mentions that she feels agitated and constantly worried around the time that her symptoms from Crohn's disease worsen for the past two months. Her sleep is affected because of the worrying, and she's tired all the time. She constantly worries that she will always be in bad health and will always be in pain and will never be able to fully pursue her dreams because of her health. What is the best treatment for this patient?

A. Counsel patient to be compliant with her medication and lifestyle changes
B. Prescribe SSRIs for anxietyC. Prescribe benzodiazepines for sleep
D. Continue medication and lifestyle changes for Crohn's disease along with CBT
E. Prescribe stronger painkillers

Answer 1

For managing worsening Crohn's disease symptoms and associated anxiety and sleep issues in a 16-year-old girl, a holistic approach that includes adherence to medication and lifestyle changes, along with cognitive behavioral therapy (CBT), is recommended over immediate pharmacological intervention for anxiety and sleep.

Step-by-step explanation:

The best treatment for a 16-year-old girl with worsening symptoms of Crohn's disease who is experiencing anxiety and sleep disturbances would involve addressing both her physical and mental health needs. Ensuring adherence to medication and lifestyle changes for Crohn's disease is crucial, as these are foundational in managing the condition. Additionally, considering the patient's psychological distress, cognitive behavioral therapy (CBT) could be beneficial, particularly as it has proven effective in managing anxiety and sleep problems. While selective serotonin reuptake inhibitors (SSRIs) may be considered for treating anxiety, it is important to proceed with caution due to potential side effects and the need for a comprehensive management approach. Therefore, the best treatment may be:

Option D: Continue medication and lifestyle changes for Crohn's disease along with CBT

This option offers a holistic approach to her health, addressing both physical symptoms and psychological concerns without the immediate use of additional medication for anxiety and sleep, which could carry nontrivial side effects. This approach aligns with current understanding and research on the effective management of Crohn's disease and associated psychological conditions.