A 12-year-old boy is brought to your clinic for being very strange in his behaviours. He is late to school because he has to be in the shower for more than 2 hours. He feels compelled to use the soap repeatedly to clean off the ‘germs’ which he is worried off. He feels compelled to do this although he thinks that it is senseless. He checks his bag for his pen every 5 minutes. He has always struggled to complete his exams in time. Which of the following is the MOST likely diagnosis?
A 12-year-old boy is brought to your clinic for being very strange in his behaviours. He is late to school because he has to be in the shower for more than 2 hours. He feels compelled to use the soap repeatedly to clean off the ‘germs’ which he is worried off. He feels compelled to do this although he thinks that it is senseless. He checks his bag for his pen every 5 minutes. He has always struggled to complete his exams in time. Which of the following is the MOST likely diagnosis?
💡 Explanation
**Core Concept**
The boy's behavior is characterized by repetitive, intrusive thoughts and compulsions to perform specific rituals to alleviate anxiety, which is a hallmark of Obsessive-Compulsive Disorder (OCD). OCD is a mental health disorder that involves unwanted and intrusive thoughts (obsessions) that trigger repetitive behaviors (compulsions) aimed at reducing anxiety.
**Why the Correct Answer is Right**
The boy's behavior involves checking his bag for his pen every 5 minutes, which is an example of a compulsion. He also has intrusive thoughts about germs, which leads him to engage in excessive handwashing. This pattern of obsessions and compulsions is a classic symptom of OCD. The boy's difficulty in completing exams on time may also be related to his obsessive thoughts and compulsive behaviors, leading to significant distress and impairment in his daily functioning.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the boy's behavior does not involve deliberate self-harm or suicidal ideation, which are characteristic of Obsessive-Compulsive Personality Disorder (OCPD).
**Option B:** This option is incorrect because the boy's behavior does not involve a preoccupation with food, eating, or weight, which are characteristic of Eating Disorders.
**Option C:** This option is incorrect because the boy's behavior does not involve a preoccupation with appearance, excessive exercise, or a fear of gaining weight, which are characteristic of Body Dysmorphic Disorder (BDD).
**Clinical Pearl / High-Yield Fact**
Repetitive behaviors and intrusive thoughts can be a manifestation of OCD, but they can also be seen in other conditions such as Tic Disorders, Anxiety Disorders, and Trauma-Related Disorders. It's essential to evaluate the individual's overall presentation, including the content and context of their thoughts and behaviors, to determine the underlying diagnosis.