Abstract

 Introduction: Obsessive compulsive disorder (OCD) is among the most prevalent and debilitating mental illnesses. Associated physical and psychiatric comorbidities furthur complicate its outlook. The present study was conducted to sort out psychiatric and major physical comorbidities among Nepalese OCD patients presenting to a psychiatric out-patient service.
 Material And Method: We used the ‘ICD-10: Classification of Mental and Behavioral Disorders’ for diagnosis and the ‘Yale Brown Obsessive Compulsive Scale’ (YBOC) for rating OCD symptoms. Psychiatric comorbidity diagnoses were made as per the ICD-10 and physical diagnoses according to the departments from or to where subjects were referred.
 Results: Of total, 45 (60%) were male. The most commonly affected age groups were 20-29 (39%) and 30-39 (32%). More than half subjects presented after more than five years of illness. Thirteen percent subjects had suicidal intents. Nearly two third subjects had presented with the YBOC score of severe range. Forty percent subjects reported past history and 55% family history of significant illness. One fourth revealed substance use and assessment indicated premorbid cluster C traits/ problems among nearly 45%. Ninteen percent had physical and 63% comorbid psychiatric disorders. Mood, mainly depressive and other anxiety disorders were the most common ones.
 Conclusion: Many of Nepalese OCD patients present late to psychiatric service when they are severely affected and have other comorbidities. Depressive and other anxiety disorders are the most common psychiatric comorbidities.
Highlights
Obsessive compulsive disorder (OCD) is among the most prevalent and debilitating mental illnesses
The objective of the study was to find out prevalence of comorbid psychiatric and major physical illness and to sort out common comorbid psychiatric disorders among Nepalese OCD patients presenting to a psychiatric out-patient service
All the patients with OC symptoms and diagnosed as OCD coming in the contact of the investigator during the study period were included after their informed consent
Summary
Obsessive compulsive disorder (OCD) is among the most prevalent and debilitating mental illnesses. Associated physical and psychiatric comorbidities furthur complicate its outlook. OCD is a chronic condition with significant morbidity, distress and dysfunction.[3,4,13] Comorbidities, which are common further complicate its outcome.[3,4,13,15,16] Depression and other anxiety are common as its co-morbid psychiatric disorders.[3,10,13,15,16] There is often delay in seeking help.[3,5,17] The disorder has been associted with high family history of psychiatric illness and other components of obsessive compulsive spectrum disorders.[4,18] Obsessive compulsive disorder (OCD) manifests with obsessions and or compulsions resulting into anxiety.[1,2,3,4] OCD is reported as one of the common psychiatric[5,6,7,8,9,10] and one of the most disabling medical disorders.[5,11,12] Its lifetime prevalence is estimated around 2%.5-8,10-12 OCD is a chronic condition with significant morbidity, distress and dysfunction.[3,4,13] Comorbidities, which are common further complicate its outcome.[3,4,13,15,16] Depression and other anxiety are common as its co-morbid psychiatric disorders.[3,10,13,15,16] There is often delay in seeking help.[3,5,17] The disorder has been associted with high family history of psychiatric illness and other components of obsessive compulsive spectrum disorders.[4,18]
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