Obsessive-compulsive disorder: Under-recognized and responsive to treatment
Mood or anxiety concerns, when explored, may reveal associated OCD symptoms. Pharmacotherapy and cognitive behavioral therapy have proven effective.
THE CASE
Ms. L is a 26-year-old woman in acute distress because of a recurrent thought. She worries: “What if I sexually molest my son?” She says she has no desire to act on this recurring thought and recognizes that it is unlikely to be true. The thought is so upsetting, however, that she has begun having panic attacks and avoids being left alone with her child.
She also reports past episodes of thoughts that she may be homosexual and thoughts that something catastrophic happened without her awareness (eg, that she unknowingly ran over someone while driving). She has attempted self-management, including trying to reason with herself, trying to stop thinking the thoughts, and seeking reassurance from her boyfriend and medical providers.
These compulsive behaviors lowered her distress temporarily, thereby reinforcing her need to check and seek reassurance.
