Interactive Case
Patient Background
Diana, 26 years old, has been struggling with excessive handwashing and an extreme fear of contamination. She spends hours each day cleaning her bathroom and kitchen surfaces. She recognizes that her fears are irrational, but cannot control the urges to clean and wash.
Diana’s symptoms have escalated in the past two months, causing her to miss work and isolate herself from family. She has tried using gloves and masks, but her anxiety remains high unless she cleans thoroughly. She reports feeling "trapped" in this cycle.
Key Assessment Findings
- Excessive fear of contamination (obsession)
- Repeated, ritualistic cleaning behaviors (compulsion)
- Insight present: She knows her thoughts/behaviors are excessive
- Anxiety level spikes if unable to perform cleaning routine
- Daily functioning significantly impaired (missing work, socially withdrawn)
Vital signs: T 36.8°C, HR 90, BP 120/72, RR 18. Diana appears restless, frequently sanitizing her hands with a personal bottle of sanitizer.
Priority Interventions
- Provide education on OCD, emphasizing that obsessions/compulsions are linked to anxiety.
- Begin Exposure and Response Prevention (ERP) therapy under supervision of mental health professionals.
- Consider SSRIs (e.g., fluoxetine, sertraline) to reduce obsessional anxiety.
- Teach relaxation and mindfulness techniques to manage anxiety.
- Encourage gradual reduction of cleaning frequency with supportive coaching.
Interactive Quiz
Q1: Which term best describes Diana’s repeated fear of contamination?
Q2: What is the primary purpose of her cleaning ritual?
Q3: Which initial therapy is most beneficial for OCD symptoms?
Q4: Which medication class is commonly used to treat OCD?