A Case of Obsessive-Compulsive Disorder (OCD) Associated with Special Japanese Cultural Background Involving Strong Fear against Entities Associated with Bad Omen

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We report an OCD case exhibiting strong fear against entities associated with bad omen was treated by exposure and response prevention behavioral therapy.　The patient was a 60-year old unemployed female.　She married at 28 years old. Soon after the marriage, her husband showed violent behavior against her in response to situations and occurrences that he did not like and the patient subsequently became to despair of her marriage.　When she was 57 years old, she first experienced strong feelings of bad omen and disgust when she saw funeral company advertisements for Japanese Buddhist altars or gravestones. After watching a TV news report on mass murder, she began to wash her hands and to change her clothes whenever she saw or touched entities or people related to “death” (for example, Buddhist priests) because she felt strong fear. When she was 60 years old, she was admitted to our hospital because she was no longer able to perform routine housework and had isolated herself in her house because of her symptoms. We observed her behavior for the first 2 weeks of admission. She agreed to undergo the exposure and response prevention consisted of 11 sessions during the admission period. As a result, she showed improvement to a degree that enabled her to go outside. She was discharged, and had no difficulties in living a normal daily life. It is relevant to report the clinical course and psychopathologic discussion in strong relation to Japanese culture.

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