Brief Answer:
Suggestive of Obsessive Compulsive Disorder.

Detailed Answer:
Hi,

I read your query and although you have described the symptoms very nicely, I was not able to figure who is the subject here.

First of all, regarding the symptoms, they are suggestive of Obsessive compulsive disorder (OCD). It is a condition in which a person gets repeated thoughts regarding something (obsession) and in response does some action repeatedly (compulsion). In this case, there are quite a few obsessions like regarding contamination/ dirt which is resulting in repeated washing, doubts resulting in repeated checking. Repetition of the same line of a song could also be a compulsion.

In addition, the anger could be the resultant mood change that usually accompanies in OCD. Worrying about health all the time could be due to anxiety.

Generally OCD starts at quite early age. You have mentioned the age of the patient as 67. I would have liked to know since when are these symptoms present. In older age, it is important to rule out another brain disease and a brain scan like magnetic resonance imaging (MRI) would be required if it has started quite late.

The person in question needs to consult a psychiatrist for initiating treatment. Treatment of OCD consists of medications and psychotherapy. Medications include selective serotonin reuptake inhibitors like Fluvoxamine or sertraline. Psychotherapy would include sessions for exposure and response prevention where a person is exposed to the obsession he/she is having and prevented from doing the compulsion. It is done in a very graded manner and requires multiple sessions.

Hope, the information provided was helpful. Please feel free to ask any follow up query that you might have.

Best wishes,

Dr. Sunil Gupta

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