Obsessive compulsive disorders: Clinical

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Obsessive compulsive disorders: Clinical

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An 85-year-old man is brought to your office by his daughter because of an inability to "throw anything away" for 2 years. She states that their house is overrun with items and that insects have begun to make homes in them. The father replies that he can get rid of things but only if he is able to sell them or find a way to trade them for fair value. He explains that he grew up during the great depression and that his father was a banker who lost everything. The father always told the patient to invest in physical goods, as "that is the only thing that retains its value in a depression." Which of the following is the most likely diagnosis?


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We all have unwanted thoughts at times that we can’t just shake off. And we also have things we want to do only in a particular way - no matter if we’re talking about washing dishes or superstitions.

But individuals with obsessive-compulsive disorder or OCD and related disorders, like hoarding disorder, experience these obsessive ways of thinking and acting in such an extreme way that it causes distress and begins to negatively impact their lives.

The causes of obsessive-compulsive disorders are not fully understood, but there are a number of risk factors.

Biological factors include hormonal imbalances, neurologic conditions, and having a family history of OCD, confirming a genetic component.

Psychological factors include trauma like sexual abuse or bullying early in life, and environmental factors include streptococcal infections, stress, and an unhealthy lifestyle.

Now, according to DSM-5, the most common disorder is obsessive-compulsive disorder.

The other 8 include hoarding disorder, body dysmorphic disorder, trichotillomania or hair-pulling disorder, excoriation or skin-picking disorder, substance or medication-induced obsessive-compulsive and related disorder, and obsessive-compulsive and related disorder due to another medical condition.

The last two are: other specified obsessive-compulsive and related disorder and unspecified obsessive-compulsive and related disorder, which are reserved for symptoms that don't fit any of the main disorders.

In terms of symptoms, the group is mainly characterized by obsessions and compulsions.

Obsessions are repeated, persistent, and unwanted thoughts, urges, or mental images that are intrusive and cause distress or anxiety.

They are hard to get rid of and usually disappear only after performing a certain action or series of actions called compulsions.

Compulsions are repetitive actions like hand washing or mental acts such as praying, counting, or repeating words silently that the individual feels driven to do in response to an obsession or according to this dreaded feeling that some rule must be applied no matter what.


Obsessive-compulsive disorder (OCD) is a mental health disorder characterized by persistent, irrational thoughts and compulsive behaviors, which take more than one hour per day and cause significant distress and anxiety. In people with OCD, compulsions themselves might be unpleasant, but their performance may bring relief and ease the distress caused by the obsession. Treatment may involve cognitive behavioral therapy, and drugs specifically selective serotonin reuptake inhibitors, such as sertraline.


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