OCD (Obsessive Compulsive Disorder)

A 19 year‑old female has a history of two psychiatric admissions, first at the age of 17 and again at 19. Her initial presentation included anger outbursts, impulsivity, intrusive thoughts, compulsive behaviors, and disturbed sleep, which began during her preparation for competitive examinations and were exacerbated by difficulties in adjustment and subsequent psychosocial stressors. Between the two admissions, she was on pharmacological treatment but required re‑hospitalization due to persistence and worsening of symptoms. Premorbidly, she was described as temperamental with limited adaptability to family members, though she maintained good scholastic performance.
During her admissions, she was consistently found to be conscious and oriented, cooperative, and able to maintain self‑care. Psychomotor activity was reduced, and her speech remained coherent and relevant with normal tone and volume. Her mood was initially irritable but later improved to euthymic, with affect congruent though less stable at first. Thought content was dominated by intrusive, ego‑dystonic ideas of parental death, accompanied by compulsive behaviors such as repeatedly watching the same movie and excessive mobile use. She also demonstrated avoidance of the toilet due to worsening obsessions, which led to poor hygiene. Despite these symptoms, her memory and judgment were intact, and her intelligence was adequate. Insight was partial initially but improved with therapy.
Currently, she is stable and manageable on an outpatient basis with a combination of pharmacological treatment and ERP therapy, along with supportive psychotherapy. Her sleep and appetite have normalized, aggression has reduced significantly, and she is participating in structured therapeutic activities. She demonstrates improved insight, better adaptability, and her obsessive thoughts and compulsive behaviors are under control. With continued adherence to therapy and medication, she is preparing to resume her further studies under professional guidance, and her prognosis is considered favorable.