Often mistaken for an eccentricity, the diagnosis and treatment of Obsessive Compulsive Disorder (OCD) has come a long way to now be considered a common mental illness. The proof is in the numbers at the OCD clinic at the National Institute of Mental Health and Neurosciences (NIMHANS).
Y.C. Janardhan Reddy, Head, Department of Psychiatry and OCD Clinic, NIMHANS says, “I remember when I was a student, there were very few patients. There were people with OCD, but they were not seeking treatment. Now, it is considered a common mental illness. From 15 to 20 patients earlier, we get 70 to 80 patients now.”
The OCD clinic is now celebrating its silver jubilee, and is said to be one of a kind in this part of the world. Apart from a three-day OCD symposium from November 11 to 13, there is also an ongoing exhibition at NIMHANS with artwork and write-ups from patients, doctors and students that speak of the various facets of living with OCD.
When should one approach a doctor
Dr. Reddy said the average time between developing symptoms and seeking treatment is much lower in India — around five years, compared to around 15 years in the USA. However, a majority of those who seek treatment are from certain sections, more so the middle or upper middle class. “They have some insight, but they’re secretive and embarrassed. Still, only a small fraction seeks help,” he said.
So, when should one approach a doctor? Dr. Reddy explained: “At one level, all these occur in normal people. Occasionally, some people are more fussy about cleanliness and dismiss random thoughts. A vast majority don’t develop OCD. If it is a source of anxiety, comes in the way of your life as an impairment, and is time consuming, one must seek help.”
Dedicated ward for OCD
While the clinic is open for walk-in consultations on Tuesdays, the composition of patients consists of 60 to 70 follow up patients and 10 new ones. There are two established treatments for OCD: therapy and drugs. The cognitive behavioural therapy sessions are between 15 to 20 sessions, lasting roughly three months, medicines are administered for three to six months depending on the severity.
In approximately six months, NIMHANS will also boast of a dedicated 20-bed ward for OCD patients. “It will be one floor dedicated for OCD patients. At any point of time, there are 10 to 15 patients admitted here, but due to the requirement of long periods of treatment, bed occupancy is an issue. Those admitted are mostly washers, cleaners and checkers. This will be a dedicated space as patients don’t want to share accommodation because of the nature of illness. Some privacy concerns will be built into the ward,” said Dr. Reddy.
With most of the research in OCD in India centred around NIMHANS, plans are also afoot to start a consortium, and around seven centres have agreed to be a part of it with NIMHANS as the lead. This will aid in bringing about standardised assessment and treatment protocols, as well as use all these centres to advance the research agenda, added Dr. Reddy.