Reference no: EM133717388

Question: A 12-year-old boy studying in the 8th grade was brought to the Psychiatry Outpatient Department with complaints of academic decline. Upon exploration, the boy reported 2 years duration of symptoms that were characterized by intrusive, unpleasant, and repetitive gory images of people engaged in violence or soaked in blood that interfered with his ability to study. He would have distressing palpitations, tremors, and fearfulness simultaneously when he experiences these images and stated that they were contrary to his innate "peaceful nature" and "habitual thinking patterns." He recognized these as absurd and irrational but claimed to be powerless in stopping them. Techniques to counter them like chanting hymns did not provide any tangible relief. Other repetitive behaviors like putting on switches repeatedly and counting objects in sets of five were being done by him as it "just didn't feel right otherwise." Of these, he clearly identified the repeated occurrence of unpleasant images like the one that distressed him the most. When he presented to us, his scholastic performance was on the decline, and this had led to strained relations with his parents. Initial explanations by the patient that he was "unable to concentrate" cut no ice with his family. It was only when the child mustered enough courage to tell his mother the details about the repeated images that his parents decided to seek help for him. The child was developmentally normal. Physical examination was unremarkable. Screening for organicity was negative. What diagnosis does the child have