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CASE REPORT
Year : 2017  |  Volume : 6  |  Issue : 4  |  Page : 233-236

A compulsion to throw away prescribed tablets in a case of childhood obsessive-compulsive disorder with attention deficit hyperkinetic disorder


Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India

Correspondence Address:
Dr. Suhas Chandran
Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mahathma Gandhi Road, Mysore - 570 004, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_2_17

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Obsessive-compulsive disorder (OCD) is one of the most complex and disabling disorders presenting to a hospital setting. Its symptomatology can mimic other psychiatric disorders, especially in children, making it confusing for the treatment team. It is often associated with comorbidities such as tics, depression, and attention deficit hyperactivity disorder (ADHD). We hereby report an instance of ADHD-OCD co-occurrence in a 16-year-old boy, who presented with a 9-year history of restlessness, obsessions of contamination, symmetry, causing harm to others, setting fire, magical thoughts, with compulsions of washing, checking, ordering and arranging, counting and repeating, swallowing stones, mental rituals, and self-mutilating behavior. Independent of these repetitive rituals, there were multiple instances throughout his schooling where he would be in disciplinary trouble due to his hyperactivity, disorganization, and inattentiveness. The resulting distress from all the above symptomatology had led to two suicidal attempts. His presentation to us was the index presentation to a psychiatric setting, and following initiation of treatment, he developed a compulsion to throw away his prescribed tablets. The interesting aspects of the phenomenology and management will be discussed.


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