Howard Hughes meets the DSM 5 criteria for obsessive compulsive disorder: the obsessions are repetitive and he tries unsuccessfully to repress his impulses. His behaviors are compulsive and serve to reduce his anxiety. Obsessions and compulsions take a long time. Furthermore, they “are not attributable to the physiological effects of a substance or other medical condition” and “the disorder is not better explained by symptoms of another mental disorder” (Butcher et al., 2014, p.195). It also has symptoms characteristic of other disorders, such as bipolar I disorder and schizophrenia. He has bursts of energy and feels like he can accomplish anything. He also claims he can actually see germs on his hands or taps. Manic episodes and visual hallucinations are not DSM 5 criteria for OCD, rather they are symptoms of bipolar I disorder and schizophrenia, respectively (Butcher et al., 2014, p.241, p.448). Therefore it is possible that Howard may have had obsessive compulsive disorder comorbid with bipolar I disorder with psychotic