A 26-year-old primary school teacher, presents to you with extreme distress. She says that her life is badly affected and she has intrusive thoughts that she recognises as senseless. She is forced to check the class room lock frequently and and hence leaves the school very late. She worries that she has left something impoant inside. She has similar problems with food checking and checking the envelops before send out any posts. At present she follows a strict set of routines for most routine activities. All of the following are good long term treatment options for Leela, EXCEPT:

Lady is presenting with intrusive repetitive thoughts that she recognises as senseless. She has compulsions as she is forced to act on the intrusive thoughts. He has a set of routines and rituals to cope with the symptoms. The diagnosis is Obsessive Compulsive Disorder (OCD). OCD is a result of abnormal seratonergic function and hence the use of Clomipramine and selective serotonin reuptake inhibitors (SSRIs) E.g. Fluoxetine are good treatment options. Cognitive behavioural therapy (CBT) and explosure and the response prevention therapy (ERP) are good psychological treatments for obsessive compulsive disorder. Ref: Shoer Oxford Textbook of Psychiatry : By Philip Cowen, Paul Harrison, Tom Burns, Edition 6, Page 203