Dissociation, “OCD IN REVERSE” and unfulfilled schizophrenia. Case of Alsu B.

Abstract

The article describes a rare clinical case of severe histrionic personality disorder featuring manifestations of an atypical obsessive-compulsive disorder (“obsessive-compulsive disorder in reverse”), which led to an erroneous diagnosis of schizophrenia and classification of the patient as disabled. Over an eight-year period of psychiatric observation, the girl was given many different diagnoses in leading Russian and foreign clinics — from somatoform, hypochondriac and obsessive-compulsive disorder to schizophreniform disorder, bipolar affective disorder and paranoid schizophrenia with an emotional and volitional defect. The article substantiates the diagnosis of histrionic personality disorder and the incorrectness of other diagnoses. The article also provides a brief review of the literature regarding the comorbidity of dissociative and obsessive-compulsive disorders.