Obsessive-compulsive disorder of vowels (rare type)

Abstract

Byline: V. Ghorpade Sir, Patients presenting with unique and rare symptoms are the best teachers of clinicians, encouraging and enabling them to become wise with passage of time. This patient presented with an obsession of VOWELS. Literature survey failed to show such documented cases, hence brief details of this unusual and rare case is presented here. A 40-year-old married male, a Christian, whose mother tongue was English, and who working as an instructor in a defense organization, presented with complaints of an irrational fixed idea of searching for vowels and consonants in the text material which he came across, resulting in intense anxiety, breathing difficulty, and confused thinking since eight years. As a child he had an extraordinary memory (after reading a book once, he could reproduce it word by word). He used to be a topper all the time, till the tenth standard, which made his relatives to have high expectations from him. This made him preoccupied with studies and ranks, almost all the time, with no inclination for relaxation. When he joined the eleventh standard in a different school he had to compete with many toppers who had joined that school, unlike the old school where he was the only topper. Despite this he was within the sixth or seventh rank, which disappointed him, but he continued to work hard. With this changed situation, his ambition was to be at least within the third position. In the year 1983, when he was 17 years old, just before attending his eleventh standard exam in English, he tried to recall what he had read and to his surprise he found his mind was blank, resulting in fear. Subsequently this fear spread to other exams also. Despite this, he could write competitive exams and come out with flying colors. One year later he developed viral fever following which he realized that his irrational fear of not being able to recall and read relapsed. With minor fluctuations in his distressful symptoms he graduated as an Engineer. He was preparing for a prestigious competitive exam during which he had a vague feeling in his mind that he should not fail. With this background, in the month of January 1998, when he was working as an instructor in a defense establishment, he was exposed to different names of squadrons with alphabets. While talking or reading he developed an urge in his mind to look for the first vowel, the sight of which used to make him anxious, which was characterized by shortness of breath, anxiety, and confused thinking, which used to last for a few minutes to few hours and remit spontaneously. This used to appear during his exams and the rest of the time he used to be apparently normal. From 1999 to 2000 he did not have any problem with the vowels. His achievement of clearing the competitive exam brought him a lot of appreciation. During the period 2000 to 2003 he had mild relapses, which he could control, and his work continued without any interruptions. …