2789 – Obsessive-Compulsive Disorder in a Patient with Crohn's Disease: A Case Report and Review

Abstract

Introduction:

Although patients with inflammatory bowel disease (IBD) are commonly described as psychorigid and scrupulous, studies about obsessive-compulsive disorder (OCD) in patients with IBD remain few.

Objectives:

To examine the links between OCD and IBD, in general, and Crohn's disease, in particular.

Methods:

A case report and review.

Results:

A twenty-one-year-old man was referred to the psychiatric outpatient clinic for obsessive ideas mainly about dirt associated with compulsive washing as well as compulsive masturbation.

Since childhood, the patient was diagnosed with Crohn's disease that led to failure to thrive. His medication included azathioprine and sulfapyridine. He developed perianal complications as well as bronchiectasis.

Obsessive-compulsive symptoms gradually dissipated on fluoxetine 30 mg qd along with supportive psychotherapy.

Conclusions:

This paper discusses the possible links between Crohn's disease and OCD. Obsessive-compulsive symptoms in patients with Crohn's disease might be due to immune-complex formation, but might also be explained from a psychodynamic point of view: association between fixation at the anal stage in OCD and lesions affecting the bowel and the perianal region in Crohn's disease.