A 27-year-old man presents with a 6-month history of increasing repetitive behavioural routines. He is now unable to leave the house without undertaking lengthy repetitive checking of locks, taps and switches. He is taking longer and longer so that he is often late for work. He is worried about losing his job as other colleagues have been made redundant. He had a similar episode when he was 19 around the time of his ‘A-level examinations but that settled within a few weeks which is why he has delayed seeking help. He wants to know what is wrong with him and what treatment options there are that do not require medication.
Mental state examination His eye contact is good. He is anxious and gently rubs his hands together without looking at them. His mood is not low subjectively or objectively. His speech is normal. There are no delusions or hallucinations and nothing else of note. What…
