Which features characterize obsessive-compulsive disorder in history taking?

• A. Delusions and hallucinations.
• B. Recurrent, unwanted intrusive thoughts (obsessions) and/or repetitive behaviors (compulsions) aimed to reduce anxiety.
• C. Mood swings with periods of elation.
• D. Memory loss and confusion.

Answer: (B)

In history taking for obsessive-compulsive disorder, the key feature is the presence of recurrent, unwanted intrusive thoughts (obsessions) and/or repetitive behaviors or mental acts (compulsions) that the person feels driven to perform to relieve anxiety. Obsessions are distressing and ego-dystonic—the person recognizes them as intrusive and unwanted—while compulsions are the ritualistic actions used to reduce the distress caused by those obsessions. A skilled history will uncover how much time these thoughts or behaviors take, how they impair daily functioning, and whether the person has insight into the irrational nature of the symptoms. This pattern helps separate OCD from conditions with true delusions or hallucinations, mood disorders with elation or instability, or cognitive disorders with memory problems.