MBBS OSCE · Psychiatry
OSCE — Obsessive-Compulsive Disorder (OCD)
Eight-minute OSCE station on Obsessive-Compulsive Disorder (OCD): focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Obsessive-Compulsive Disorder (OCD).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Obsessive-compulsive disorder (OCD) is a chronic, disabling mental disorder characterised by obsessions (intrusive, unwanted, recurrent thoughts, images or urges that cause marked anxiety or distress) and/or compulsions (repetitive behaviours or mental acts the person feels driven to perform to neutralise the obsession or prevent a dreaded outcome), that are time-consuming (over 1 hour per day) or cause clinically significant distress and impairment. Patients have insight (recognise the obsessions as irrational) but cannot resist them — this distinguishes OCD from psychosis (no insight), delusional disorder and OCPD (ego-syntonic). Common themes: contamination/washing, doubt/checking, symmet
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Obsessions and compulsions taking over 1 hour per day and causing significant di |
| Safety | Sudden-onset OCD in a child with tics, choreiform movements or urinary symptoms |
| Safety | OCD unresponsive to two SSRI trials + ERP - clomipramine; antipsychotic augmenta |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.