A patient comes to the emergency department complaining of fears of being contaminated by her college roommates. She admits that since entering college several months ago, she has been showering at least six times a day because of these fears and anxiety. She also admits knowing that her behavior does not make sense. Which of the following most accurately describes this condition?

Obsessive-compulsive disorder

Explanation

• With OCD, obsessions are recurrent, persistent, intrusive, and unwanted. Thoughts, images, or impulses cause marked anxiety and interfere with interpersonal, social, and occupational function.

• This differs from a psychotic disorder because the patient is aware that the behavior is irrational or unnecessary. The compulsions are ritualistic or repetitive behaviors carried out in an attempt to neutralize anxiety.

• Obsessions and compulsions are not characteristic symptoms of schizophrenia, generalized anxiety disorder, or phobias.

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