Final answer:
Fred's symptoms of anxiety and compulsive hand washing suggest he would likely be diagnosed with Obsessive-compulsive disorder (OCD), as his actions are impeding his daily life.
Step-by-step explanation:
Fred is fixated on cleanliness and his behaviors suggest he is dealing with a condition where he experiences significant anxiety and engages in compulsive behaviors – specifically, incessant hand washing – in an attempt to mitigate that anxiety. Given the description of his symptoms, which include anxiety when he cannot wash his hands, and the compulsion to wash to the point of physical harm, Fred would most likely be diagnosed with Obsessive-compulsive disorder (OCD). This diagnosis is supported by the fact that his actions are interfering with his ability to focus on other aspects of his life, a key characteristic of OCD.