[Difficulties in treating obsessive-compulsive disorder with cognitive-behavioral therapy - a case report]

Obsessive-compulsive disorder (OCD) is characterized by the occurrence of recurrent obsessive thoughts and / or compulsive actions that cause discomfort, suffering and disrupt the functioning of the patient. According to the ICD-10 classification, a minimum two-week duration of the disorder is required, and the DSM-5 classification specifies that symptoms should occur for at least one hour a day. The most common symptoms can be divided into four groups: symmetry/ rituals, gathering/collecting, washing/cleaning, controlling. Functional neurovascular studies indicate changes in the cortico-striatum-thalamocortical circuits (CSTC, cortico-striato-thalamo-cortical), which play a key role in the development of the symptoms of obsessive-compulsive disorder. OCD treatment includes pharmacological, psychotherapeutic and psychoeducational interventions. It is believed that in the case of OCD with a predominance of intrusive activities, psychotherapy is more effective than pharmacotherapy. Currently, the focus is placed on the research relevant to clinical practice on the effect of therapy and its effectiveness in the treatment of the disorder. The aim of a case presentation is to answer the following questions: what factors could have contributed to a significant improvement in selected symptoms and little or no improvement in others, in the context of an individual patient's life history, comorbidity and psychosocial situation, and to propose an adequate treatment based on available data or to extend diagnostics.