Obsessive Compulsive Disorder (OCD) is mainly evaluated and diagnosed through detailed psychiatric examination. The severity of OCD, its impact on the patient's functionality, and in which areas it affects should be investigated. The scale most commonly used in these senses to evaluate the patient is the Yale-Brown obsessive compulsive scale (Y-BOCS). This is a semi-structured scale administered by the clinician. It can also be applied by obtaining information from a relative who can give information about the patient and the situation. Various dimensions of the disease are evaluated, including the severity of obsessions and compulsions, the time spent on them, inhibition, distress caused by them, resistance and control. Those with 16 points and above are considered OCD. If a scale is not applied, it should be recorded how much time the patient spends with obsessions and compulsions in a day, and how much effort he makes to avoid obsessions and resist compulsions. Age at onset of the disease, course of the disease, past treatment history, medications used, medications with benefits and side effects, psychotherapy history, family approach, psychosocial stressors, which areas of life the disease affects and how, should be investigated. Patients should also be evaluated for comorbid psychiatric diseases and other comorbid medical diseases. In particular, suicidal ideation should be carefully evaluated in terms of suicide planning.
In the evaluation process of OCD; It is important not to overlook biological factors related to the triggering of OCD. Most of the time, when your patient goes to your doctor, if there is a risk for his/her condition, research will have already been done or will be done. What are these? If there is a refractory OCD picture or a past history of head trauma, headache, etc., it can be examined with Cranial MRI. Biochemical examinations of thyroid functions, vitamin B12, vitamin D, magnesium, folic acid and anemia can be performed. Again, in resistant cases, autoimmune examinations can be performed. If the condition is accompanied by neurological symptoms, neurology consultation may be requested. In female patients, the menstrual pattern should be learned, and if there is an irregularity, gynecology referral may be made. Although more common in children, your patient's OCD symptoms may occur after an infection in the body (especially beta hemolytic If streptococci) occur and occur together with a tic disorder, research and treatment should be carried out on this issue.
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