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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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