Obsessive-compulsive disorder.

The patient has a general sense that something terrible may occur if a particular ritual is not performed, and the failure to perform a ritual may lead immediately to severe anxiety or a very uncomfortable, nagging feeling of incompleteness. In addition to checking and washing rituals, patients with OCD often present with persistent intrusive thoughts, extreme slowness or thoroughness, or doubts that lead to reassurance-seeking rituals. Patients with OCD commonly seek care from physicians other than psychiatrists. For example, in one study, 20 percent of patients who visited a dermatology clinic had OCD, which had been previously diagnosed in only 3 percent. 2