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  Psychopathology of washing compulsions in obsessive-compulsive disorder:  Not all patients wash for the same reasons.  Obsessive-compulsive disorder (OCD) is a heterogeneous disorder in terms of the contents of obsessions and compulsions. Washing, being one of the most frequent compulsion modalities, has been associated with different variables such as: physical or mental contamination fears, fears associated with negative affect (including disgust) and the loss of control, a high level of perfectionism, or the avoidance of a sense of dirtiness or incompleteness. In this study, these variables are examined through the descriptive analysis of the psychopathological symptoms and treatment responses of three patients with OCD and washing rituals as their main diagnosis. Both the clinical analysis and the evaluation through self-reports reflect the motivational heterogeneity associated with a same symptom expression, washing, and suggest the need to consider these variables in the individualized treatment of each patient. Resumen:  El trastorno obsesivo-compulsivo (TOC) es un trastorno heterogeneo en cuanto al contenido de las obsesiones y compulsiones. El lavado, una de las compulsiones mas frecuentes, se ha asociado a diferentes variables como: el miedo al con­tagio fisico o mental, el miedo al afecto negativo y a la perdida de control, un elevado perfeccionismo o la evitacion de la sen­sacion de suciedad o de inacabado. En este trabajo se examinan estas variables a traves del analisis descriptivo de la sintomato­logia psicopatologica y la respuesta al tratamiento de tres pacientes con diagnostico principal de TOC que realizan rituales de lavado. Tanto el analisis clinico como la evaluacion a traves de autoinformes muestran la heterogeneidad motivacional que subyace a una misma expresion sintomatica, el lavado, y sugieren la necesidad de tener esta variable en cuenta en el abordaje terapeutico individualizado de cada paciente.

Psicopatología de las compulsiones de lavado en el trastorno obsesivo-compulsivo: no todos los pacientes lavan por los mismos motivos