A Case Study of Obsessive Impulsive Disorder
A Case Study of Obsessive-Compulsive
Disorder: Some
Diagnostic Considerations
INTROD UCTION
Prior to 1984, obsessive-compulsive disorder (OCD) was considered a rare disorder and one difficult to treat (I ) . In 1984 the Epidemiologic Catchment Area
(ECA) initial survey results became available for the first time, and OC D prevalence figures showed that 2.5 % of the population m et diagnostic criteria for OCD (2,3) .
Final survey results published in 1988 (4) confirmed these earlier reports. In addition, a 6-month point prevalence of 1.6% was observed, and a life time prevalence of 3.0% was found. OCD is an illness of secrecy, and frequently the patients present to physicians in specialties other than psychiatry. An other factor contributing to under diagnosis of this disorder is that psychiatrists m a y fail to ask screening questions that would identify OCD. The following case study is an example of a patient with moderately severe OCD who presented to a resident psychiatry clinic ten years prior to being diagnosed with OCD. The patient was compliant with out patient treatment for the entire time period and was treated for major depressive disorder and border line personality disorder with medication s and supportive psychotherapy. The patient never discussed her OCD symptoms with her doctors but in retrospect had offered many clues that might have allowed a swifter diagnosis and treatment.
CASE HISTORY Simran Ahuja was a 29 year old, divorced, indian female who worked as a file clerk. She was followed as an out patient at the same resident clinic since 1971. I first saw her 2012.
PAST PSYCHIATRIC HISTORY
Simran had been seen in the resident out patient clinic since July of 1984. Prior to this she had not be en in psychiatric treatment. She had never been hospitalized . Her initial complaints were depression and anxiety and she had been placed on an phenelzine and responded well. Her depression was initially thought to
Disorder: Some
Diagnostic Considerations
INTROD UCTION
Prior to 1984, obsessive-compulsive disorder (OCD) was considered a rare disorder and one difficult to treat (I ) . In 1984 the Epidemiologic Catchment Area
(ECA) initial survey results became available for the first time, and OC D prevalence figures showed that 2.5 % of the population m et diagnostic criteria for OCD (2,3) .
Final survey results published in 1988 (4) confirmed these earlier reports. In addition, a 6-month point prevalence of 1.6% was observed, and a life time prevalence of 3.0% was found. OCD is an illness of secrecy, and frequently the patients present to physicians in specialties other than psychiatry. An other factor contributing to under diagnosis of this disorder is that psychiatrists m a y fail to ask screening questions that would identify OCD. The following case study is an example of a patient with moderately severe OCD who presented to a resident psychiatry clinic ten years prior to being diagnosed with OCD. The patient was compliant with out patient treatment for the entire time period and was treated for major depressive disorder and border line personality disorder with medication s and supportive psychotherapy. The patient never discussed her OCD symptoms with her doctors but in retrospect had offered many clues that might have allowed a swifter diagnosis and treatment.
CASE HISTORY Simran Ahuja was a 29 year old, divorced, indian female who worked as a file clerk. She was followed as an out patient at the same resident clinic since 1971. I first saw her 2012.
PAST PSYCHIATRIC HISTORY
Simran had been seen in the resident out patient clinic since July of 1984. Prior to this she had not be en in psychiatric treatment. She had never been hospitalized . Her initial complaints were depression and anxiety and she had been placed on an phenelzine and responded well. Her depression was initially thought to