Background: Once perceived to be rare in childhood, obsessive compulsive disorder (OCD) is now
recognized to be fairly common among children and adolescents. However, lack of recognition of the disorder
and delays in treatment continue to be frequent. The occurrence of unusual or unfamiliar symptoms may be
one of the reasons for under-detection of OCD. Obsessions related to romantic relationships have been described
in adults; usually these involve doubts and fears about the relationship.
Method: We report an uncommon obsessional fear of getting into a romantic relationship in an adolescent girl
who had been previously well functioning. This patient experienced significant distress and dysfunction due
to these repetitive thoughts. After intervention with medication and cognitive behavioral therapy her symptoms
diminished and she returned to pre-morbid functioning.
Discussion: Unusual presentations of the symptoms may lead to diagnostic confusion and delay in treatment.
In adolescents, for example, who are navigating one of the normal developmental challenges—intimacy, are
vulnerable to develop anxiety, which may manifest unusually as OCD. It is essential that clinicians recognize
how varied the nature of obsessions can be.