case report ocd xyzxyzxyzppt- FINAL.pptx

Educational and informative

1. Robin Baghla 1 , Prof.( Dr. )Sudhir Kumar 2 , Prof.( Dr. ) Haseeb Khan 3 , Dr. Astha Singh 4 , Dr Neha Nilakh 1 1 Junior Resident, 2 Professor & Principal, 3 Professor & Head, 4 Associate Professor Department of Psychiatry Hind Institute of Medical Sciences Safedabad , Barabanki , Uttar Pradesh. Presenter - Dr. Robin Baghla A rare case report of Obsessive Compulsive Disorder (OCD) with urinary obstruction-related obsessions and compulsions.

2. ABSTRACT This case report presents an uncommon manifestation of Obsessive-Compulsive Disorder (OCD) where the patient's obsessive thoughts and compulsive behaviors with primary focus on urinary obstruction-related issues . The patient's condition significantly impacted his daily life and necessitated a multidisciplinary approach for diagnosis and management.

3. INTRODUCTION OCD typically presents with common themes such as contamination, checking and intrusive thoughts about harm or morality. However, OCD can occasionally manifest with highly specific and rare obsessions and compulsions, reflecting the diverse nature of the disorder. This report aims to provide insight into a unique presentation centred around urinary obstruction-related obsessions and compulsions.

4. CASE DESCRIPTION 35yr old married male was referred by urologist to psychiatry OPD. Presenting complaints comprised of intrusive persistent thoughts regarding sudden stoppage of urination, if he found that someone was entering or leaving the house or saw mosquito in toilet. In case he sees shadow of person at toilet door while urinating, he was unable to urinate as he feels another person wants to urinate and waits for person to urinate following which he micturates. He reports always being ambivalent about going to toilet. After urinating, his anxiety used to slightly alleviate, but complete satisfaction was not achieved.

5. In order to urinate more effectively, he listened to inspiring videos while turning off his phone to avoid disturbance by texts or calls. Since as he had text or calls while urinating, pt had to stop finish with the call or reverting back to text then only urine use to pass. He visits toilet 20 to 25 times a day, staying there for 15 to 20 minutes each time, but never felt bladder completely empty. He spends most time of day thinking about urine and visiting toilets. Patient is having these symptoms since 12-15yrs. As per the patient symptoms have largely impacted his personal, professional & social life.

6. MSE General Appearance & Behavior - P a tient presented as well-groomed and appropriately dressed 35-year-old male. There were signs of mild anxiety , with frequent glances towards the restroom. Restlessness & occasionally shifting uncomfortably in his seat was also noted during the interview. Speech: Speech was coherent and relevant. P atient expressed himself clearly, although there was a noticeable urgency in discussing his urinary concerns.

7. Mood & Affect: P redominant mood was anxious. Affect seemed constricted, with intermittent expressions of fear and distress, particularly when discussing thoughts about urinary obstruction. Thought Process: Thought process was linear, but patient frequently digressed to elaborate on his fears of urinary blockage. There was evidence of obsessive thought patterns, with an inability to redirect attention away from these concerns. Thought Content & Possession: The patient reported persistent, intrusive thoughts related to the fear of not being able to empty his bladder completely. These thoughts were distressing and preoccupied a significant portion of his daily life.

8. Cognition: Cognition appeared intact, as evidenced by coherent conversation and appropriate responses to questions unrelated to urinary concerns. Insight: I nsight into irrational nature of his fears was present. P atient recognized that his thoughts were excessive but felt compelled to engage in rituals to alleviate anxiety. (Grade 3) Judgment: J udgment is intact.

9. Clinical Assessment: Physical examinations and urological investigations ruled out any organic cause for the patient's concerns. Psychiatric evaluation revealed classic features of OCD, including recurrent, intrusive thoughts of urinary blockage and an overwhelming need to perform rituals related to urination. Treatment and Outcome: The patient was started on a combination of selective serotonin reuptake inhibitors (SSRIs) & cognitive-behavioral therapy (CBT) tailored to address his specific obsessions and compulsions. Over the course of several months, there was a noticeable reduction in symptom severity. Regular follow-ups demonstrated significant improvement in the patient's overall quality of life.

10. Discussion - Report highlights a rare presentation of OCD focused on urinary obstruction -related obsessions and compulsions. It emphasizes importance of recognizing and addressing unconventional symptomatology to ensure appropriate treatment and improved outcomes. Conclusion - OCD can manifest in diverse and unexpected ways, as demonstrated in the case. Early diagnosis, tailored treatment plans & psychoeducation for patients and their families are essential in managing rare presentations.

11. REFERENCES

12. THANK YOU !