Akademik Veri Yönetim Sistemi
38th ECNP Congress, Amsterdam, Hollanda, 11 - 14 Ekim 2025, ss.1-50, (Özet Bildiri)
Introduction: In obsessive-compulsive disorder (OCD), recurrent obsessions and compulsions that cause severe anxiety may be present either separately or together. The aetiology of OCD involves many genetic, neurochemical, structural and psychodynamic factors.
Aim: This case report aims to present the clinical presentation, course and treatment process of a 14-year-old female patient whose condition was triggered by a teacher's behaviour when she was eight years old.
Case: A 14-year-old female patient was brought to the hospital by her parents, complaining of intrusive thoughts, feeling forced to talk about religion and feeling restless. During the interview, she avoided eye contact and seemed restless. It emerged that the patient had doubts and religious obsessions, such as feeling unsure whether she had performed her ablutions correctly and becoming uneasy when she saw shapes resembling crosses, like the letter 't'. She also had doubts about whether she had prostrated herself before Atatürk when she saw his photograph. Her contamination obsessions caused her to feel dirty when she touched something, and she had compulsions, such as frequently washing her hands. It was established that the patient's initial symptoms emerged at the age of eight, characterised by a fear of causing harm through touch and an intense desire for approval. Her classroom teacher was authoritarian, yelling and punishing her for mistakes, and her father was also strict and authoritarian. The patient was diagnosed with OCD and a multifaceted treatment plan was developed.
Method: The patient and her family were followed up with regular weekly interviews for approximately 2 months. Psychoeducation was given to the patient and her family about the diagnosis and the adolescence process. The patient was asked to write a "Self-Composition" and an "Anxiety List". The book "OCD is Now in My Hands" was recommended, homework was given -for a maximum of one chapter per week- and studied with the patient. Sertraline 50 mg/day was initiated based on the patient's diagnosis, and the dose was planned to be increased if necessary. Since the complaints continued during the control examinations, the dose of Sertraline was first increased to 75 mg/day, then to 100 mg/day, and Aripiprazole 2.5 mg/day was added to the treatment schedule in the following period. The patient's complaints have improved by 60-70% with treatment.
Discussion: In terms of the persistence of OCD symptoms, environmental factors are thought to be more important in girls and genetic factors in boys. In our case, the family history of psychiatric illness was considered as the predisposing factor, and the uncompromising, harsh and punitive disciplinary methods of the father and the class teacher, who were male authority figures, were considered as the triggering factor.
Conclusion: A review of the literature reveals a limited number of studies in which OCD is triggered in the paediatric age group by the attitude of classroom teachers. This case study contributes to the existing literature and emphasises the importance of gathering information on the relationships between patients presenting with OCD symptoms and their teachers.