03/08/2026
Am I Clean enough?
Mr. Ismail was a 23-year-old, single, diploma student who came for consultation with complaints of recurrent thoughts that his body was dirty with repetitive washing for 7 months. He presented with obsessions with the themes of contamination whereby he repetitively thought that his body, hands and feet were contaminated. His obsession and compulsion are time consuming, that took up more than 8 hours a day. He experienced significant distress with social and academic functional impairment. Mr. Ismail also began to experience depressive symptoms. There were no history of psychosis and other anxiety symptom.
Mr. Ismail had normal birth, growth and developmental history. He had no medical illness.Since young, Mr. Ismail had high expectations of himself especially with his academic performance. He had self-criticism and he would self-blame, felt guilty and demotivated whenever he could not achieve his goals. Hewas a school prefect and an excellent student who did well in both his academic and extracurricular activities. He grew up as a perfectionist who always aimed for perfection and could hardly tolerate mistakes or imperfections.
During Mr. Ismail's session, he was found to be anxious. He complained of low mood with obsessions following the themes of contamination. I was glad that Mr. Ismail had a very good insight regarding his conditions. His physical examinations were normal. Mr. ismail was diagnosed to have Obsessive Compulsive Disorder, OCD, with good insight. He also has comorbid depression. He was started on both pharmacological and psychotherapy.
Obsessive Compulsive Disorder, (OCD) is characterized by obsession and/ or compulsion that lead to significant distress with functional impairment. Patients can have recurrent intrusive thoughts of contamination, doubts, need of symmetry and so on. Many of them have to perform rituals, commonly like washing or checking in order to reduce their anxiety. Treatment are available in the form of medication, usually Selective Serotonin Reuptake Inhibitors and psychotherapy, usually Exposure Response Prevention therapy.
Mr. Ismail had good adherence to his treatment and outpatient follow ups. He performed well in his final pre-university examination. During his last visit with us, he was more cheerful and less anxious. He was preparing to take up his degree course in public universities.
All the best to you, Mr Ismail! 😊
(Patient 's identity and storyline were modified to protect his confidentiality)
Love
Dr Gan Ning Xin
Psychiatrist
Klinik Pakar Gan dan Rakan-Rakan (Psikiatri)
Kajang.🩷