Obsessive-Compulsive Symptoms during Depressive Episode in Non-OCDPatients: A Prospective Observational Follow-Up Study

Background: Obsessive-Compulsive-Disorder (OCD) and depression are well-known co-morbidities. But Obsessive- Compulsive-Symptoms (OCS) also occurs in non-OCD patients during depression as associated-symptoms, which has neither been adequately researched nor reflected in the nosology. This study systematically tried to look into the OCS during depressive episode in non-OCD patients. Methods: This was an observational follow-up study done at Central- Institute-of-Psychiatry, India. Male and female patients aged 18-55 years diagnosed by ICD10 as depressive episode single, recurrent or bipolar having no history of OCD treated as both in and out-patient were included in the study spanning over a period of six months. All the patients were screened with Yale-Brown- Obsessive-Compulsive-Symptoms-(YBOCS)-checklist. Patients having OCS were further rated with YBOCS-rating-scale and Hamilton-Depression-Rating-Scale (HDRS)-21-points at first contact and after six-to-eight weeks of treatment. Results: OCS was found in nearly one-third of non-OCD depressive-patients (45-male and 34-female) in this study of which 50% had premorbid-anankastic-traits. Contamination-washing-symptoms were commonest in females while obsessions of aggression and symmetry in males. There was significant correlation of OCS with low-mood, psychicanxiety and weight-loss. Mean HDRS-total-score correlated significantly with YBOCS-obsession-score but not YBOCS-compulsion-score. Irrespective of choice-of-treatment, improvement in depression and OCS corroborated with each-other and patients showing inadequate improvement had multiple-OCS at baseline. Conclusion: OCS is found in nearly one-third of non-OCD depression with corroboration of severity and treatment response, thus may be considered as a specifier for depression in future.