Scenario 7: Obsessive-Compulsive Disorder (OCD) A 17-year-old male high school junior comes to the clinic to establish care. He recently moved from a relatively urban area to a very rural area and has just started his junior year in a new school. The mother states that she has noticed that her son has been frequently washing his hands and avoids contact with any dirty or soiled object. He uses paper towels or napkins over the knob on a door when opening it. According to the mother, this behavior has just appeared since moving

. The patient, upon close questioning, admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is worried about all the germs the boys are carrying around. Past medical history is noncontributory. Social history -lives with parents and 2 siblings in a house in a new town. Is an honors student. Based on these behaviors, The APRN thinks the patient has obsessive-compulsive disorder (OCD). Question 1 of 2: What is primary pathophysiology of OCD? Obsessive-compulsive disorder (OCD) is a mental disorder that is characterized by absurd, recurrent, and uncontrollable thoughts that lead to anxiety, followed by repetitive behaviors aimed at reducing anxiety. The primary pathophysiology of OCD is overly persistent and uncontrolled neural activity in SMS, possibly as a result of dopamine-serotonin imbalance. For instance, in the case scenario, the patient admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is also