Patients with somatic obsessions are worried about the possi-bility that
they have or will contract an illness or disease. In the past, the most common
somatic obsessions consisted of fears of cancer or venereal diseases. However,
a fear of developing AIDS has become increasingly common. Checking compul-sions
consisting of checking and rechecking the body part of concern, as well as
reassurance seeking, are commonly asso-ciated with this fear. While it may be
difficult to distinguish the somatic obsessions of OCD from those of
hypochondriasis. Somatic obsessions are more easily dis-tinguished from
somatization disorder in which patients with somatic obsessions usually focus
on one illness at a time and are not preoccupied with a diverse, apparently
unrelated array of somatic symptoms.
People with sexual or aggressive obsessions are plagued by fears that
they might harm others or commit a sexually unacceptable act such as
molestation. Often, they are fearful not only that they will commit a dreadful
act in the future but also that they have already committed the act. Patients
are usually horrified by the content of their obsessions and are reluctant to
divulge them. It is striking that the content of these obsessions tends to
consist of ideas that patients find particularly abhorrent. Patients with these
highly distressing obsessions frequently have checking and confession or
reassurance rituals. They may report themselves to the police or repeatedly
seek out priests to confess their imagined crimes
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