Introduction
Based on the diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) obsessive-compulsive disorder (OCD) is defined as the experience of recurrent and persistent thoughts, urges, or images (obsessions) that are intrusive and unwanted, causing significant anxiety or distress. Despite the limited literature on OCD in the elderly, it is estimated that approximately 0.7 percent of older adults may be affected by this condition. This disorder can be one of the most disabling mental health conditions. The World Health Organization (WHO) has classified it as one of the top 10 most disabling illnesses worldwide. Understanding the first-hand experiences of older adults with OCD can provide useful information for therapists and caregivers of this population.

Methods & Materials
This is a descriptive phenomenological study. The study population consists of older adults diagnosed with OCD, referred to counseling centers in Isfahan, Iran, in 2022. A purposeful sampling method was used to select eligible people. The inclusion criteria were the OCD diagnosis based on the DSM-5 criteria and a score above 23 on the Yale-Brown OCD scale, no severe physical or psychological comorbidities, a minimum age of 60, and willingness to participate in the study. Semi-structured interviews were conducted, lasting 60 minutes. After 10 interviews, data saturation was achieved. 
Each interview was conducted in a room located in a counseling clinic. The interviews began with general questions about their lived experiences of OCD followed by probing questions to gather more in-depth information. The general questions addressed the problems caused by the disorder, effective factors, coping mechanisms, and perceptions about the causes of the disorder. Probing questions such as “What do you mean?”, “Can you explain more?”, “Can you give an example?” were used to explore various aspects of the lived experiences. The interviews were recorded with the participants’ consent. The recordings were transcribed verbatim. To address any ambiguities in the coding process, the interview transcripts were reviewed in collaboration with the participants. The data were analyzed using Colaizzi’s seven-step method as following: Thoroughly reading the transcripts, extracting significant statements, interpreting the statements (drawing meaning), grouping the meanings into clusters of themes, deriving comprehensive descriptions based on the phenomenon, reporting the importance of the phenomenon, and verifying the findings by returning to the participants, asking them about the findings, and confirming their accuracy.

Results
The investigation of the lived experiences of older adults with OCD revealed four main themes: Fluctuating self-esteem, dysfunctional attitudes, relational dissatisfaction, and lack of self-compassion. The first theme had the following sub-themes: Self-deprecation, helplessness, being wronged in life, waste of life, and social stigma of OCD. The second theme had the following sub-themes: Normalizing obsessions and superstitious thinking. The third theme had the following sub-themes: Problematic interactions with spouse and troublesome social interactions. The final theme had the following sub-themes: Emotional distress, neglect of physical care, and fruitless struggles.

Conclusion
This is the first study that explored the lived experiences of Iranian older adults with OCD. The findings suggest that they experience relational, social, and attitudinal problems. They experience more feelings of loneliness, not being understood, or missing out on life than other older adults.

Ethical Considerations
Compliance with ethical guidelines
Prior to the study, the study objectives were explained to the participants, and informed consent was obtained from them. They were assured of the confidentiality of their information. This study was approved by the Ethics Committee of Islamic Azad University, Khomeini Shahr Branch, Iran (Code: IR.IAU.KHSH.REC.1402.011).

Funding
This study was extracted from the PhD thesis of Sedighe Afshar, at the Department of Counseling, Faculty of Humanities, Islamic Azad University, Khomeini Shahr Branch, Iran. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.

Authors' contributions
The authors contributed equally to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all the participants for their cooperation in this research.

 

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