Phenomenology of obsessive compulsive disorder in a Sri Lankan patient population

Abstract

Introduction: Obsessive-compulsive disorders (OCD) are characterised by obsessional thinking and compulsive behaviour. Obsessional symptoms include thoughts, ruminations, impulses, ‘phobias’, images and rituals. Compulsions are overt or covert. The themes are diverse. Phenomenological differences may have implications in prognosis and response to treatment. Aims: To study phenomenological aspects and their prevalence in patients with OCD in a Sri Lankan setting. Methods: Descriptive study. Patients meeting ICD-10 criteria for OCD attending a tertiary care hospital as out-patients were interviewed using a semi-structured questionnaire. Results: The Sample size was 55 with 32 males. The mean age was 24.5 years with a mean duration of illness of 32 months. Thirty three had obsessional thoughts, 23 had doubts, 13 had ruminations, 8 had images, 5 had urges and one had an obsessional phobia. Twenty six patients had more than one type of symptoms. The themes included dirt and contamination, orderliness, sexual themes, aggression, fidelity of partner and others. Thirty-five had overt compulsions only, 13 had covert compulsions only, 5 had both types; no compulsions were identified in two. The compulsions were   checking, cleaning, arranging and dressing. Fifteen had more than one type of compulsion. Twenty-five had co-morbid ICD 10 diagnoses, the commonest was depression. Conclusions: The sample had a diversity of phenomenological forms. Obsessional thoughts were commonest; dirt and contamination was the commonest theme; checking was the commonest compulsion.DOI: http://dx.doi.org/10.4038/sljpsyc.v5i1.7077 SL J Psychiatry 2014; 5 (1): 18-20