14th February 2025

A 45-year-old man with a background of eczema, obsessive-compulsive disorder and Tourette’s syndrome has spent 2-3 hours per day in the last fortnight performing repetitive rituals which he feels are out of his control.

A 45-year-old man with a background of eczema, obsessive-compulsive disorder and Tourette’s syndrome has spent 2-3 hours per day in the last fortnight performing repetitive rituals which he feels are out of his control. His wife is concerned as this is out of character for him and he has been late to work 6 times.

His GP advises him to attend A&E due to the behavioural change. They organise a CT scan of his head and routine bloods which are non-concerning.

Observations – RR 19, Sa02 99% on room air, HR 76, BP 166/112, T 37.1

Due to low clinical suspicion, they decide not to organise a lumbar puncture. He is discharged home.

Which of the following would qualify as an obsession?

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