Case Study:01 (OBESSIVE COMPULSIVE SCALE)

Introduction
Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring,
unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do
something repetitively (compulsions). The repetitive behaviours, such as hand washing,
checking on things or cleaning, can significantly interfere with a person’s daily activities
and social interactions.

Many people without OCD have distressing thoughts or repetitive behaviours. However,
these thoughts and behaviours do not typically disrupt daily life. For people with OCD,
thoughts are persistent, and behaviours are rigid. Not performing the behaviours
commonly causes great distress. Many people with OCD know or suspect their obsessions
are not realistic; others may think they could be true (known as limited insight). Even if
they know their obsessions are not realistic, people with OCD have difficulty disengaging
from the obsessive thoughts or stopping the compulsive actions.

Obsession:

 Fear of being contaminated by germs

 Fear of causing harm to yourself or others
 Intrusive sexual thoughts
 Excessive focus on religious or moral ideas
 Fear of losing things
 Order and symmetry
 Superstitions such as excessive attention to something considered lucky or unlucky

Compulsion:

 Excessive double-checking of things, such as locks

 Counting, tapping to reduce anxiety
  Excessive washing or cleaning
 Ordering or arranging things
 Asking from loved once if they are safe or checking them to make sure they are
safe
 Excessive praying and involve in religious rituals in response to fear of punishment
Saving un wanted things in their rooms in response to fear that if they throw them
they will be unlucky (superstitions)

CASE REPORT

Socio-Demographic Data

Name : Miss H
Age : 23
Gender : Female
Marital Status : Unmarried
Religion : Hindu
Socio Economic Status : Middle
Occupation : Nil
Domicile : Urban
Informant : Friend
Reliability : Reliable and consistent

Chief Complaints
According to client
The client was reported that “mein cheezo ko rakh kar bhul jati hu” Mein apna zayada time
cheezo ko unki sahi place par lagane par lagati hu jis kar k mera bhaut kaam reh jata hai.”
She further said that “who kahi par jati hai toh wha par bhi things ko sahi karne lag jati
hai.” She spends most of time in kitchen where she arranges the utensils and counting
them. She also spends a lot of time in bathroom to bath and go to toilet.
Complaints by Family

1. Avoid social gathering

2. Get annoyed soon without any reason
3. Soliloquize Person (Talk to oneself)
4. Worries a lot and get panic very often
5. She spends most of time in arranging clothes in almirah

History of current Problem

The above symptoms have been reported last one month. Miss H is 23-year-old female.
She states that she enjoyed oneself talking. She denies any depression and suicidal
thoughts. She does not like party and noise. She states that she feels nervous when
unknown person to talk to her. She reports that she forgets things last one year ago. She
gets panic when guest come at home. She stated that even she cannot carry routine work.

Past Psychiatry History

Client does not have any prior psychiatric treatment. She had never hospitalized.

Medical History
She had no medical history of illness.

Biological Functioning
Sleep - Not sleeping properly from 2 days
Appetite - Normal
Energy -Low
Family History

Father Mother

Brother Brother Client

Client having a very healthy relationship with their family. The client’s mother is a
housewife and father is a businessman. She stated that she was very close to her mother;
her mother always listens to her and always available to talk with her. She has two elder
brother and they share good bond.
Family Structure: Joint
Parenting style: Authoritarian
Relationship with client between other family members: Cordial
Pattern of communication: ineffective

Family History of illness:

There is no any mental illness in the client family but father is a diabetic patient last five
years.
School History
The client was good in academic. Till 10+2 grade she doesn’t take study seriously but in
higher study she doing well in study. But she never participated in any school or college
function. She said she having a stage phobia. She never repeated any class.

Behavior Checklist

Question Yes No
Feels Hopeless
Anger
Low self esteem
Thumb Sucking
Poor time
Management
Peer Issues
Bed wetting
Introvert

Pre-Natal Factors (State of Mother During Pregnancy)

Conception: Planned
Health of the mother: Nutrition status: Average
Infections: No
Physiological/Psychological illness: None

Perinatal Factor (including Neonatal)

Term- Full
Delivery Place- Hospital
Type- Normal
Head injury- No
Post Natal Factor
Infections: No
Feeding Problem: No
Injury: No
Convulsions fits: No
Feeding History: Both (Exclusive and bottle) till 5 years

Personal History
Birth Order- Youngest

Birth and development history

Normal delivery and milestone were achieved on time and no childhood
disorder found.

Pre-Morbid Personality
Character traits: Introvert
Use of leisure time: No use of leisure time
Attitude to self: Self-conscious
Initiative: Low on initiation
Faith in Religious: Yes
Organized and Systematic: Yes

MENTAL STATUS EXAMINATION

General Appearance and Behavior
General appearance is neatly dressed, normal gait and appropriate facial
expression. The client has touched the surrounding. She maintained proper
eye contact. Rapport could be established with client and there was positive
attitude towards the examiner.

Movement and Behavior

Slow psychomotor movement is observed from the client.

Speech
The speech was normal. Intensity and speed of communication of the client
was normal. There was no pressure of speech and it was coherent and goal
directed.

Mood/Affect
Subjectively: “I’m anxious”,
Objectively: the client is anxious and tired
The depth or intensity of mood is normal. The mood is stable. They are
congruent to the thought.

Thought
The client has preoccupation of illness.

Perception
No perceptual disturbance could be elicited from the client.

Cognitive Functions
 The client was oriented to time, place and date
 Attention and concentration are aroused and sustained
 Memory:
Immediate memory: Intact
Recent Memory: Intact
 Remote Memory: Intact

 Attention: Intact
 Judgement:
Personal: Intact
Social: Intact
Test: Intact

Insight

The insight level of the person is grade 3 means awareness of being

sick but blaming it on others, on external factors, or on organic
factors.