A patient with obsessive-compulsive disorder spends 2 hours each morning checking and rechecking her home before leaving for work then comes home on the lunch hour and spends more than an hour rechecking faucets, stove burners, appliances, window and

Question

door locks, and so forth. The checking continues after work and during the evening. The patient spends so much time in ritualistic behavior that grooming is poor and social activities are nonexistent. Which indicators for measuring progress would be appropriate for this patient? Select all that apply. a. Denies the presence of anxiety or distress
b. Participates in a social activity 30 minutes per day
c. Checks no more than once when leaving home
d. Calls to a neighbor to check the home in her absence
e. Achieves adequate grooming and hygiene daily
f. Meditates or completes deep breathing each week

Answer 1

B, C, E
Social isolation, disruptive checking, and inadequate grooming are problems for this patient, and thus it is desirable to have outcomes indicating progress in reducing these concerns. It would be unrealistic to expect anyone to be devoid of anxiety. Mild to moderate levels of anxiety occur regularly in most people and serve to motivate appropriate response to stress in all persons. Calling the neighbor to assist in checking indicates a continued excessive need to check. Although meditation and deep breathing are helpful interventions, achieving these once per week is probably insufficient to achieve meaningful benefits, and their completion does not necessarily mean that the target symptoms/diagnoses have improved.