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How to deal with poor socialization and obsession in cleanliness?

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Posted on Wed, 18 May 2016
Question: Doctor, It is for my elder sister. the symptoms are very confusing. we are very much hurt & disturbed to see it all. some current symptoms are
she wont socialize, she has stopped going to work for the last 8/9 years, she dont like strangers or anyone, she wont talk but she sometimes keep on speaking, she hates the idea of going to doctor for any reason.
she washes and cleanses everything. She seem to consider everything dirty. she wont like the family members also. she will show anger at all times. please help how we may proceed with the diagnosis and treatment. any reference, any center where we can keep her. pliz guide.
doctor
Answered by Dr. Ashish Mittal (22 hours later)
Brief Answer:
Need to meet nearby psychiatrist first.

Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     36 year old female
•     Education: MBBS
•     Complains of: Poor socialization, do not talk, stopped working for 8-9 years, do not like strangers, sometimes keep on speaking (muttering to self), excessive washing/cleaning, excessive anger and unwillingness to show doctor.

From the history and nature of dysfunction, your sister is less likely suffering from PTSD.

From the history it appear that she is probably suffering from psychosis with obsessive-compulsive symptoms.
In psychosis common symptom are:
Patient talks to self, becomes irritable on minor things and does not want to go to doctor due lack of insight about the problem.

In her case as patient is unable to understand her state of mind due to illness process, it is better to meet nearby psychiatrist first (Not Psychologist). As she does not recognize her symptoms try to persuade her for treatment of common symptoms like: stress, anxiety, sleep problem, any headache or other pain complaint and fear.

It is difficult to persuade such cases to see Psychiatrist specially if patient is herself doctor, but you need to do that.

Search nearby psychiatrist and visit psychiatrist with patient (without patient if she does not go) to confirm diagnosis and start treatment. Sometime forced treatment, medicines in food or short admission may be needed in uncooperative patients.

I hope this information has been both informative and helpful for you.
Wishing her good health.
Regards
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1859 Questions

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How to deal with poor socialization and obsession in cleanliness?

Brief Answer: Need to meet nearby psychiatrist first. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 36 year old female • Education: MBBS • Complains of: Poor socialization, do not talk, stopped working for 8-9 years, do not like strangers, sometimes keep on speaking (muttering to self), excessive washing/cleaning, excessive anger and unwillingness to show doctor. From the history and nature of dysfunction, your sister is less likely suffering from PTSD. From the history it appear that she is probably suffering from psychosis with obsessive-compulsive symptoms. In psychosis common symptom are: Patient talks to self, becomes irritable on minor things and does not want to go to doctor due lack of insight about the problem. In her case as patient is unable to understand her state of mind due to illness process, it is better to meet nearby psychiatrist first (Not Psychologist). As she does not recognize her symptoms try to persuade her for treatment of common symptoms like: stress, anxiety, sleep problem, any headache or other pain complaint and fear. It is difficult to persuade such cases to see Psychiatrist specially if patient is herself doctor, but you need to do that. Search nearby psychiatrist and visit psychiatrist with patient (without patient if she does not go) to confirm diagnosis and start treatment. Sometime forced treatment, medicines in food or short admission may be needed in uncooperative patients. I hope this information has been both informative and helpful for you. Wishing her good health. Regards