30th November 2023

A teenage girl of 18 years who has pemphigus vulgaris is accompanied by her mother to your clinic

A teenage girl of 18 years who has pemphigus vulgaris is accompanied by her mother to your clinic due to concerns about some peculiar behaviours. After further discussion, you discover that she has been experiencing extreme anxiety regarding her university application. She confesses to feeling compelled to switch every light on and off five times every morning, as failing to do so exacerbates her worries about getting into university. She has a PMH of depression.

Which of the following features would point towards a diagnosis of psychosis over obsessive-compulsive disorder?

Select the SINGLE most appropriate option from the list below. Select ONE option only.