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Clinical Crossroads Update
February 27, 2002

A 45-Year-Old Woman With Obsessive-Compulsive Disorder, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2002;287(8):1037. doi:10.1001/jama.287.8.1037

At Psychiatry Grand Rounds in October 2000, Michael A. Jenike, MD, discussed a 45-year-old woman with obsessive-compulsive disorder (OCD).1 Mrs T described symptoms of OCD dating back to childhood. In her 20s she was hospitalized for depression, but no one diagnosed her OCD. In her 30s she recognized her own diagnosis while watching a television show about OCD. Subsequently, Mrs T benefited greatly from cognitive behavior therapy and medications. However, she had major difficulty tapering the use of paroxetine (75 mg/d), with fever, aches, and shaking for months. At the time of the conference, she was beginning to feel anxious and wondered if she needed to restart the medication.