American Journal of Psychiatry and Neuroscience

2018; 6(4): 99-103

http://www.sciencepublishinggroup.com/j/ajpn
doi: 10.11648/j.ajpn.20180604.12
ISSN: 2330-4243 (Print); ISSN: 2330-426X (Online)

A Comparative Study of Socio Demographic and Clinical

Profiles in Patient with Obsessive Compulsive Disorder
and Depression
Jaisingh Raman, Sivabalan Elangovan*, Thirunavukarasu Manickam
Department of Psychiatry, SRM Medical College & Research Centre, Tamilnadu, India

Email address:
*
Corresponding author

To cite this article:

Jaisingh Raman, Sivabalan Elangovan, Thirunavukarasu Manickam. A Comparative Study of Socio Demographic and Clinical Profiles in
Patient with Obsessive Compulsive Disorder and Depression. American Journal of Psychiatry and Neuroscience.
Vol. 6, No. 4, 2018, pp. 99-103. doi: 10.11648/j.ajpn.20180604.12

Received: September 8, 2018; Accepted: October 4, 2018; Published: October 23, 2018

Abstract: Introdution: Most often patients suffering from OCD also have depressive symptoms, which might be secondary
to the OCD and its burden to the quality of life, or it might be independent to OCD. The same way Depression also has some
obsessive manifestation. The presence of depressive symptoms is the important factors, which make patient with OCD as
suicidal. Suicidal tendencies in OCD always correlated with severity of depressive symptoms. But in clinical settings, we most
often missed to evaluate suicidal tendencies and other comorbidities of OCD. So this study mainly focuses on various socio
demographic differences and clinical profiles of patient with OCD and depression. Materials and Methods: This is a case
control study, 30 consecutive patients with OCD as well as 30 consecutive patients with depression, attending psychiatry
department of Stanley Medical College Hospital included in this study as cases and controls. Then both cases and controls
analyzed for socio demographic profile and clinical profile. RESULTS: Compared with patients with major depression, OCD
patients are young (p=0.017), predominantly males (p=0.019), more educated (p=0.003) and more often associated with
suicidal ideation (p=0.024) Conclusion: Obsessive-compulsive disorder most often has depressive manifestations. The
comorbid depressive symptoms make patients with OCD with suicidal ideations. It is essential to look for depressive
symptoms in OCD in order to prevent suicidal attempts.
Keywords: Obsessive Compulsive Disorder, MDD, Suicidal Ideations, Clinical Profile, Comorbidities

1. Introduction
Obsessive Compulsive disorder (OCD) is a common, OCD patients also experience two or more co-morbid
chronic disabling and often debilitating disorder, marked by psychiatric conditions during their lifetime. However, OCD
obsessions and compulsions. The cardinal features of has not received due attention of the clinicians, researchers
obsessive-compulsive disorder (OCD) include obsessions, and policy makers because it is a non-psychotic illness.
compulsions, or both that are time-consuming and cause One of most common comorbid condition in OCD is
clinically significant distress or impairment in social, depression. Most often patients suffering from OCD also
occupational, or other areas of functioning [1]. have depressive symptoms, which might be secondary to the
Obsessive-compulsive disorder, which was once thought to OCD and its burden to the quality of life, or it might be
be uncommon condition, has been increasingly recognized independent to OCD. The same way Depression also has
now. The lifetime prevalence of this disorder is between 2 to some obsessive manifestation. The presence of depressive
3% in general population. It is twice as prevalent as symptoms is the important factors, which make patient with
schizophrenia and bipolar disorder and the fourth most OCD as suicidal. Suicidal tendencies in OCD always
common psychiatric disorder. Above all, 50 - 60% of the correlated with severity of depressive symptoms. But in
100 Jaisingh Raman et al.: A Comparative Study of Socio Demographic and Clinical Profiles in Patient with
Obsessive Compulsive Disorder and Depression

clinical settings, we most often missed to evaluate suicidal 2.7. Controls

tendencies and other comorbidities of OCD. So this study
mainly focuses on various socio demographic differences and 30 consecutive patients who satisfied the criteria for
clinical profiles of patient with OCD and depression. depression according to ICD 10 diagnostic criteria attending
the OPD, Stanley Medical College Hospital, Chennai.
1.1. Aim
2.7.1. Inclusion Criteria
To Asses Socio-Demographic profile and clinical profile (1) Diagnosed as Depression according to ICD 10 criteria.
of Patient with Obsessive Compulsive Disorder and (2) Willing to provide informed consent for the interview.
Depression (3) No evidence of organic disease.
1.2. Objectives 2.7.2. Exclusion Criteria
(1) Uncooperative patients
To Asses and compare Socio-Demographic profile and (2) Refusal to participate in study.
clinical profile of Patient with Obsessive Compulsive (3) Patients with evidence of organic disease.
Disorder and Depression (4) Depression with psychotic features.

2. Materials and Methods 2.8. Tools

2.1. Setting of Study (1) Semi structured proforma for socio demographic Data,
a) Age
The study was carried out at the psychiatry OPD at b) Sex
Government Stanley Medical College and Hospital, Chennai. c) Educational Status
d) Marital Status
2.2. Study Period e) Employment Status
The study was carried out over a six month period from f) Socio economic status
January 2009 to June 2009. g) Family history
(2) Self checklist for Obsessive - Compulsive disorders
2.3. Study Sample (OCD)
(3) Yale Brown obsessive compulsive scale (Y Bocs)
30 consecutive patients who satisfied the criteria for (4) Hamilton Depression rating scale (Ham-D).
obsessive compulsive disorder and 30 patients who satisfied
the criteria for depression according to ICD 10 diagnostic
criteria were recruited for the study. 3. Statistical Analysis
2.4. Design of Study The cases and controls were analysed for the study
findings. Frequency distribution was done using EPI 6 Info
Case Control Study. (WHO). For comparison, we used chi square tests for testing
the association and the difference in means was calculated
2.5. Selection of Sample using student 't' test. These tests were performed using SPSS
30 consecutive patients fulfilling the inclusion criteria version 16. In addition, we generated some charts using the
were taken as the study sample. Microsoft word. Important findings of relevance, both
30 consecutive patients fulfilling the inclusion criteria positive and negative are presented and discussed.
were taken as the control population.
4. Results
2.6. Cases
4.1. Socio Demographic Information
2.6.1. Inclusion Criteria
(1) Diagnosed as obsessive compulsive disorder according The cases and controls were compared for the following:
to ICD 10 criteria. age, gender, marital status, living status, religion, educational
(2) Duration of illness greater than six months. level and employment status. Compared with depressives,
(3) No evidence of organic disease. OCD patients are younger and this difference is statistically
(4) Willing to provide informed consent for the interview. significant (p = 0.017). Compared with depressives, there are
more male OCD patients this difference is statistically
2.6.2. Exclusion Criteria significant (p = 0.019). There is statistically significant
(1) Uncooperative patients difference for educational level between the cases and
(2) Refusal to participate in the study. controls; more OCD patients have secondary and high levels
(3) Duration of illness less than six months. of education compared with depressive patients.
(4) Patients with evidence of organic disease. There are no statistical difference for marital status,
(5) OCD with psychotic features. religion, employment status and place of residence between
 American Journal of Psychiatry and Neuroscience 2018; 6(4): 99-103 101

the cases and controls. In our study 30 patients fulfilled the criteria of obsessive
compulsive disorder. Out of 30 patients 13 patients had "fear
4.2. Clinical Profiles of contamination" and an equal number presented with
4.2.1. Family History "washing" compulsion. Most of the studies in India and the
It is important to observe that 36.7% of OCD patients have world found that the fear of contamination is the commonest
a family history of psychiatric disorder compared with 20% obsession and washing is the commonest compulsion
of depressive patients but this difference was not statistically amongst OCD patients.
significant. It is observed that no statistically significant In our study four patients had pathological doubt with
difference exist between the two groups for family history of checking compulsion. Among the four patients, one patient
substance abuse and suicide / attempted suicide. had mixed obsessive (sexual obsessions) features. Three
Overall, there exists no difference between the cases and patients had obsessive thought of fear of harming others
controls in family history of psychiatric disorder, substance (aggression). Three patients had obsession for symmetry.
use and suicide/attempted suicide. The compulsions seen in the study participants included:
cleaning/washing, checking, repeating acts, order and
4.2.2. Substance Abuse symmetry, mental compulsions and counting. These clinical
It is observed that no statistically significant difference features are similar to what is being observed in most clinical
exist between the two groups for history of alcohol use. studies of Obsessive Compulsive Disorder.
4.2.3. Suicidal Attempt 4.2.5. Severity of symptoms
It was observed that 9 out of 30 OCD patients at least have About a half of the patients (46.7%) spent more than three
1 episode of attempted suicide in the recent past but among hours but less than 8 hours every day on obsessions; more
depression only 2 out of 30 patients have history of attempted than a third of them (36.7%o) spent more than 8 hours every
suicide. This difference is statistically significant one. P day on their obsessions. About a half of OCD patients
value is 0.024. (46.7%>) had impaired levels of functioning due to their
obsessions and 43.3%) of the patients had incapacitating
4.2.4. Clinical Features of Obsessive Compulsive Disorder levels of interference due to their obsessions. Distress due to
The clinical features of the thirty patients with Obsessive obsessions was severe in 46.7% of cases and near constant
Compulsive Disorder was studied in greater detail. Clinical and disabling among 43.3%) of OCD patients. About three
description of the patients was recorded in detail utilizing the fourths (73.3%) of the OCD patients had no control over
psychiatric interview schedule that is used in our clinic their obsessions. About two thirds of OCD patients (63.3%o)
settings. Content analysis of the mental status examination completely yielded to their obsessions.
was done and examples of specific obsessions and
compulsions noticed in this group are presented.
Table 1. Comparison of age between Obsessive Compulsive Disorder (cases) and Depression (controls).

Cases/Controls N Mean Std. Deviation df value 'p' value

Cases (OCD) 30 29.3333 7.64890 58 -2.448 .017*
Controls (Depression) 30 36.3000 13.58028

Table 2. Comparison of Socio- Demographic profile between Obsessive Compulsive disorder (cases) and Depression (controls).

Variables OCD DEPRESSION STATISTICAL SIGNIFICANCE

Male 19 10 P=0.019*
Gender
Female 11 20 Chi= 5.406
Married 16 23 P=0.058
Marital status
Unmarried 14 7 Chi= 3.59
Hindu 24 26 P=0.488
Religion
Others 6 4 Chi= 0.48
Illiterate &Primary 5 16 P=0.003
Education
Secondary & above 25 14 Chi= 8.86
Employed 7 5
P=0.77
Occupation Unemployed 16 15
Chi= 3.275
Others (Student & Housewife) 7 10
Urban 23 24 P=0.852
Resident
Rural 7 6 Chi= 0.32
102 Jaisingh Raman et al.: A Comparative Study of Socio Demographic and Clinical Profiles in Patient with
Obsessive Compulsive Disorder and Depression

Table 3. Comparison of Family History between Obsessive Compulsive disorder (cases) and Depression (controls).

Variables OCD DEPRESSION STATISTICAL SIGNIFICANCE

Yes 11 6 P=0.126
Family History of psychiatric illness
No 19 24 Chi= 2.052
Yes 6 4 P=0.365
Family History of substance abuse
No 24 26 Chi= 0.48
Yes 6 8 P=0.381
Family History of suicide and attempted suicide
No 24 22 Chi= 0.373

Table 4. Comparison of Clinical profile between Obsessive Compulsive disorder (cases) and Depression (controls).

Variables OCD DEPRESSION STATISTICAL SIGNIFICANCE

Yes 6 2 P=0.127
History of substance abuse
No 24 28 Chi= 2.308
Yes 9 2 P=0.024*
History of attempted suicide
No 21 28 Chi= 5.189
Yes 2 3 P=0.5
History of any medical comorbidities
No 28 27 Chi= 0.218

Table 5. Frequency distribution of severity of obsession and compulsion symptoms elicited by y-bocs in patients with obsessive compulsive Disorder (n =30).

Symptoms None Mild Moderate Severe Extreme

1 0 1 (3.3%) 4 (13.3%) 14 (46.7%) 11 (36.7%)
2 0 0 3 (10%) 14 (46.7%) 13 (43.3%)
3 0 0 3 (10%) 14 (467%) 13 (43.3%)
4 0 0 3 (10%) 8 (26.7%) 19 (63.35)
5 0 0 2 (6.7%) 6 (20%) 22 (73.3%)
6 5 (16.7%) 4 (13.3%) 7 (23.3%) 13 (43.3%) 1 (3.3%)
7 5 (16.7%) 3 (10%) 4 (13.3%) 13 (43.3%) 5 (16.7%)
8 6 (20%) 2 (6.7%) 4 (13.3%) 14 (46.7%) 4 (13.3%)
9 5 (16.7%) 1 (3.3%) 4 (13.3%) 10 (33.3%) 10 (33.3%)
10 5 (16.7%) 1 (3.3%) 4(13.3%) 4 (13.3%) 16 (53.3%)

Table 6. Severity of symptoms in cases and controls.

Mild Moderate Severe Extreme

OCD 6 (20.1%) 4 (13.3%) 7 (23.3%) 13 (43.3%)
Depression 10 (33.3%) 2 (6.7%) 4 (13.3%) 14 (46.7%)

Table 7. Comparison of HAM-D total score between Obsessive compulsive disorder (cases) and Depression (controls).

Cases/Controls N Mean Std. Deviation 'P’ value

Cases (OCD) 30 16.6 8.5646 0.001*
Controls (Depression) 29 26.3 4.936 0.001*

nature of illness in the psychiatric disorders among family

5. Discussion members.
Very interesting finding in this study is more number
We found a predominance of younger persons in our patients with OCD have history of attempted suicide than
sample compared with Depressives. Findings suggest that patients with depression. There are many published studies
younger adults and older adolescents may be particularly reporting higher risk of suicidality in OCD patients, as well
prone to develop OCD, while older individuals may display as studies describing increased risk of suicidality in OCD
OCD less frequently (2). We also found the OCD patients to patients with other comorbid psychiatric conditions such as
be more educated compared with depressives. Some clinical major depressive disorder (MDD) and posttraumatic stress
studies have suggested that higher IQs and educational disorder (PTSD) [4–12]. That is why OCD has been
achievements characterized individuals with OCD (3). considered as debilitating illness like schizophrenia.
Family history of psychiatric disorder was high among the Comorbid depression, sexual obsession, female sex is
OCD patients, it is already suggested that there might be an important contributory factors for suicide in OCD (13). One
"OCD spectrum" of disorders that share some of the same study described that a patient with long history of both MDD
vulnerability genes, such as Tourette syndrome, body and OCD who developed suicidal obsessions (14).
dysmorphic disorder, grooming behaviors and obsessive- Distress due to obsessions was severe in about half of our
compulsive personality disorder (2). We have not assessed cases and near constant and disabling among 43% of OCD
the nature of psychiatric disorder among the family members patients. About three fourths of the OCD patients had no
of OCD patients. It is desirable that in future we identify the control over their obsessions and about two thirds of OCD
 American Journal of Psychiatry and Neuroscience 2018; 6(4): 99-103 103

patients completely yielded to their obsessions. Many studies compulsive disorder: a description of a Brazilian sample and a
have observed that the symptoms are quite distressing systematic review of international clinical studies. J Psychiatr
Res. 2004 Jul-Aug;38(4):403-11.
causing significant handicap to the person. WHO has
included OCD among the leading ten handicapping illness. [4] Angelakis, P. Gooding, N. Tarrier, and M. Panagioti,
The common symptoms presented in our sample are cleaning “Suicidality in obsessive compulsive disorder (OCD): A
/ washing, checking, repeating acts, order and symmetry, systematic review and meta-analysis,” Clinical Psychology
Review, vol. 39, pp. 1–15, 2015.
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6. Limitations Fontenelle, M. C. Do Rosario, and E. C. Miguel, “Suicidality ´
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The study was conducted in tertiary care context, a symptom dimensions and comorbid conditions,” Journal of
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