Obsessive-Compulsive Disorder (OCD) and Psychosurgery; Delusion of the Effectiveness as the Only Treatment Method in a Patient with Treatment-Resistant Disorder

Introduction: Obsessive-compulsive disorder (OCD) is a complex neuropsychiatric illness characterized by intrusive and persistent obsessive thoughts along with dysfunctional and ritualized behaviors. Severe and treatment-resistant OCD is a chronic and debilitating disorder that causes considerable suffering. At least ۱۰% of patients with OCD will experience severe symptoms resistant to multimodal treatment.معرفی بیمار : Case Presentation: The patient is a ۲۸-year-old man, single, a graduate, an employee, and the second child of a family. His problem started about ۲.۵ years ago in the form of disturbing thoughts of fear of physically harming others. This problem has led to anxiety throughout the day, isolation, feelings of anger and worry, reduced self-confidence, and loss of job positions. During this period, he has used various types of medication with the appropriate dose and duration as prescribed by different psychiatrists and several cognitive behavioral therapy (CBT) courses. He also mentions tinnitus from a few months ago, which has also been resistant to medication. In the course of treatment, he received ۶ sessions of electroshock therapy (ECT) on an outpatient basis, which did not have a specific effect on the improvement of symptoms. He has had a history of recent suicide attempt due to disappointment in treatment and anhedonia with previous planning and taking ۲۱۰ tablets of acetaminophen codeine. The brain MRI of the patient was reported to be normal. The patient considers the only effective treatment to be Psychosurgery and has stopped taking all his medications some time ago.

Keywords:

Obsessive-compulsive Disorder , Treatment-resistant , Psychosurgery , Delusion