Case of a Woman Who Thinks That Her Body is Covered with Germs

A 26-year-old woman comes to see a psychiatrist because she has been taking showers for 6 to 7 hours daily. She explains, “It all starts when I wake up. I am sure I am covered in germs; if I don’t wash, I will get sick. If I don’t wash, I get paralyzed with anxiety. Once I’m in the shower, I have to shower in a particular order.

If I mess up, I have to start over, which takes hours and hours. My skin is cracking and bleeding because I spend so much time in the water.” What is the most likely diagnosis for this woman? NOTE: No other information about the patient is available. *This Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only.