International Journal of Neuroscience and Behavioral Science 7(3): 29-39, 2019 http://www.hrpub.org
DOI: 10.13189/ijnbs.2019.070302
Clinico-epidemiological Profile of Obsessive Compulsive
Patients in a Tertiary Care Hospital in Mangalore, India:
A Retrospective Study
Nitin Joseph
1,*
, Prima Cheryl D'Souza
2
, Apurav Singh
3
, Tobin P Joseph
3
, Rahul Kondaveti
3
,
Mancy Mothsera
3
, Fathima Noureen Kilikkot
3
1
Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
2
Department of Psychiatry, Kasturba Medical College Hospital, Attavar, Mangalore,
Manipal Academy of Higher Education, Manipal, India
3
Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
*
Corresponding Author: drnitinjoseph@gmail.com
Received October 17, 2019; Revised November 30, 2019; Accepted December 4, 2019
Copyright©2019 by authors, all rights reserved. Authors agree that this article remains permanently open access under
the terms of the Creative Commons Attribution License 4.0 International License
Abstract Introduction: Obsessive-compulsive
disorder (OCD) is the fourth most common mental illness.
It is associated with a wide range of functional impairments
and therefore adversely affects the quality of life of patients.
Objectives: To assess the risk factors, clinical features and
management practices of OCD based on findings were
stated in medical records. Methodology: The secondary
data from the medical records of 9 OCD patients admitted
in a tertiary care hospital over the past 10 years were
recorded in a semi-structured proforma. Severity of OCD
was assessed using Yale Brown Obsessive Compulsive
Scale scores. Results: Mean age of onset among all patients
(n=9) was 27.9±15.2 years. Family history of OCD was
reported among 3(33.3%) patients. Six had predominant
obsessions while the rest 3 had mixed type. The most
common type of obsession was of sexual type reported
among 3 patients. The most common compulsion reported
was the checking type which was present among 2 patients.
Reduced concentration, suicidal ideation and anhedonia
were present each among 5(55.6%) patients. Depression
was the most common co-morbidity reported among
5(55.6%) patients. Severity of OCD was mild among
5(55.6%). Fluvoxamine was the most common drug
[5(55.6%)] used to treat OCD. Outcome of treatment was
reported poor among 3(33.3%) patients. It was
good/moderate among 1(25%) patient residing in urban
area in comparison to 5(100%) from rural areas (p=0.048).
Conclusion: Mean age of onset was found to be delayed
among patients probably due to delay in identification of
OCD. Hence awareness generation and early screening
need to be initiated for early identification of OCD. The
majority of OCD patients had positive history of suicide
ideation and depression as co-morbidity, indicating the
need of screening patients for these conditions.
Keywords Obsessive Compulsive Disorder, Risk
factors, Clinical Features, Management
1. Introduction
Obsessive-compulsive disorder (OCD) is the fourth
most common mental illness following phobias, substance
abuse and depression. [1] Two out of every three patients
develop OCD at an early age.[2] OCD is associated with
less likelihood of completion of elementary school
education [3], lower rates of marriage [4], less work
productivity [5], disability, higher rates of unemployment,
and a wide range of functional impairments [5]. It therefore
adversely affects the quality of life of the patients. [6] It
also makes the OCD affected person easily dependent on
others and thereby impacts their family life much more
than other anxiety disorders. [2] In spite of the long term
problems associated with OCD, it has not yet received the
due attention of clinicians, researchers and policy makers.
[1]
More than half of the OCD patients experience two or
more co-morbid psychiatric conditions during their
lifetime. [1] It is associated with high rates of major
depression, social phobia [7], schizophrenia [8], bipolar
disorder [8], and poor long-term social adjustment [9].
People may fear stigmatisation at work place, and often
have concerns about disclosing its presence to their
employers, family members and friends.[10] This could be
the reason behind its under diagnosis. Poor insight and