1. Including: obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, hair pulling disorder, skin itching disorder, olfactory involvement disorder, hypochondriasis disorder 2. Common characteristics: persistent, intrusive, undesired obsessive thoughts, preoccupation Concepts and repeated obsessive behaviors have similar pathophysiological basis and treatment methods

Definition: It is a mental illness whose main clinical manifestations are recurring obsessive thoughts, compulsive impulses or compulsive behaviors.

Causes: 1. Heredity: familial aggregation, the prevalence of first-degree relatives is 4 times that of the general population 2. Neurobiological factors: such as brain trauma, cortico-striatal-thalamo-cortical pathway, 5-HT dysfunction 3 , Psychosocial factors: psychological factors, negative emotions, life events 4. Psychological explanation

Clinical manifestations: (1) Obsessive-compulsive ideas [repeated, persistent, intrusive thoughts, concepts, images, emotions, impulses or intentions that have no practical significance and are against personal will] [core]: 1. Obsessive-compulsive thinking: with Concepts, images and impulsive thoughts that repeatedly enter the patient's mind in a stereotyped manner. Although these thoughts are involuntary and objectionable, the patient believes that they belong to him. 2. Compulsive thinking: about some common things, concepts or Thinking about the phenomenon repeatedly, inquiring deeply, knowing that it has no practical significance, but unable to control it 3. Forced suspicion 4. Forced opposing ideas 5. Forced association 6. Forced recall 7. Forced intention: a strong inner impulse to do something contrary Things you want to do, but generally do not turn into actions (2) Compulsive behaviors [reduce anxiety and pain caused by obsessive ideas]: 1. Forced inspection 2. Forced washing 3. Forced questioning 4. Forced counting 5. Obsessive rituals Action (3) Avoidance behavior (4) Others: anxiety, depression, local injury, bad interpersonal relationships

Diagnosis: 1 Key points of diagnosis: (1) Main manifestations: obsessive thinking, obsessive behavior, or both (2) Time: must occupy a certain period of time (such as occurring for 1 hour or more every day) (3) Severity: causing obvious symptoms Painful or causing damage to life, family, social, education, career, etc. 2 Insight: (1) Good insight: Realize that symptoms may not be real or accept that they are not real (2) Poor insight : Awareness that symptoms may be real (3) Lack of insight: Completely convinced that symptoms are real most or all of the time

Differential diagnosis: 1. Schizophrenia: People with schizophrenia have hallucinations, delusions, disordered speech and behavior and other other psychotic symptoms. Whether they are distressed or indifferent to them, and whether they are coordinated with the environment and reality. 2. Depressive disorder: the two often coexist. Depend on which symptom is the original one and takes the initiative. If it is difficult to distinguish between them, priority will be given to depressive disorder. 3. Generalized anxiety disorder: The difficulty in distinguishing lies in anxiety and obsessive thinking. GAD focuses on daily real-life problems. It perceives threats in the outside world, the content is vague, and it is disturbing ominous omens. The patient does not think that worry is inappropriate and does not lead to compulsive ritual behaviors. The content of obsessive thoughts is mostly unusual. Things that are unacceptable 4. Phobia: Common points: fearful behavior, avoidance behavior 5. Brain organic mental disorder

Treatment: (1) Drug treatment [the main method, sufficient dosage (maximum dose of prescription) for a full course of treatment]: 1. Acute phase: treatment for 10-12 weeks, the first-line drug is SSRIs (fluoxetine); the second-line drug is tricyclics Antidepressants 2. Consolidation phase and maintenance phase: last for 1-2 years (2) Psychotherapy: exposure-response prevention (3) Physical therapy: ECT - electroconvulsive therapy, rTMS - transcranial magnetic stimulation, DBS - deep brain stimulation

Definition & Basic Characteristics & Diagnostic Key Points: There are no physical defects or only minor defects, but they always think that they have defects, or exaggerate their minor defects, feel that they are ugly or disgusting, and have attracted the attention of others. a mental illness

Clinical manifestations: 1. Thinking that the appearance is defective or ugly 2. Feeling noticed and ridiculed 3. Feeling ugly and not wanting others to know, avoiding social places 4. Spending a lot of time checking, modifying, and covering up defects 5. Affecting social functions 6. With depression, suicide risk is high

Diagnosis: 1. Having a persistent (such as at least 1 hour a day) preoccupation with the appearance that there are abnormalities or multiple flaws or being ugly, or believing that the overall appearance is ugly, but it is insignificant or undetectable in the eyes of others 2. Because of these self-perceived problems Feeling ashamed of flaws or ugliness usually includes self-involved ideas, such as the belief that others will notice, evaluate, and discuss these flaws or ugliness. 3. Preoccupation meets any of the following characteristics: (1) Repeated or excessive behavior, such as repeatedly looking at appearance (such as (Looking in the mirror, comparing yourself with others), exaggerating the severity of perceived flaws or ugliness (2) Trying to cover up or change flaws (such as performing unnecessary cosmetic surgery) (3) Avoiding things that increase the pain caused by perceived flaws or ugliness Social situations or things 4. Symptoms cause obvious pain to the patient, or cause personal, family, social, educational, occupational, etc. harm

Differential diagnosis: 1. Normal appearance concern: degree of preoccupation, frequency of repetitive behaviors, and degree of symptom distress 2. Generalized anxiety disorder 3. Social anxiety disorder: comorbidity 4. Anorexia nervosa: only focus on low body weight idealization

Treatment: 1. Medication: SSRIs 2. Psychotherapy

Hoarding disorder is a compulsive disorder characterized by the endless collection of useless or low-value items and the unwillingness to discard them, thus occupying a large amount of space. Closely related to social anxiety, withdrawal and dependent personality traits

Hair-pulling disorder is a chronic disease characterized by recurring and irresistible urges to pull out hair, resulting in significant hair loss. Formerly known as trichotillomania (trcolomania)

Skin-picking disorder (SPD) or skin-picking disorder (excoriation disorder) is characterized by repeated and compulsive picking of the skin, formerly known as pathological skin picking disorder. SPD can cause patients pain, affect their social and occupational functions, and disrupt their studies and work.

Olfactory reference disorder (alaclary relerence disorder) is an obsessive-compulsive disorder characterized by persistent preoccupation with the presence of bad odors or other unpleasant odors in the body. These smells are insignificant or difficult to detect to others. Even if the smell exists, others do not pay much attention to it.