Three decades of specialized care for obsessive-compulsive disorder (OCD): the clinical profile of patients seeking treatment at the OCD Clinic, NIMHANS, Bangalore

Background: The OCD clinic, NIMHANS has catered to individuals with OCD and related disorders since its inception in 1997. It functions as a specialised clinic with both a walk-in and referral service. Patients are evaluated and offered pharmacological, psychological and somatic therapies on an inpatient and outpatient basis. The initial evaluation includes a detailed clinical history, structured diagnostic questionnaires, and OCD severity rating using the Yale-Brown Obsessive-Compulsive Scale (YBOCS) by trained clinicians. Aim: To describe demographic and clinical characteristics at first visit, of individuals seeking treatment at the OCD clinic between 1997 and 2020. Results: Baseline information was available for a total of 2269 patients. Mean age at presentation was 29.9±10.76 years (range=10-72), 62.1% were male. More than half (52.5%) hailed from states all over India other than Karnataka. The mean duration of illness at presentation was 8.21±7.54 years, and 41.3% had a juvenile-onset. The average YBOCS score at baseline was 23.27±8.26. Most common comorbidities were major depression (19.5%), anxiety disorders (8%), psychosis (6%) and bipolar disorder (3%). 19% of patients were drug-naive at presentation. 27.7% had already received ≥2 adequate SRI trials before presentation, and 10.6% had received CBT. Conclusions: Unlike that of most other OCD specialty centres in the world (e.g., Brazilian OCD Research Consortium), our profile is unique in that it represents both patients with severe or resistant illness, as well as those who are treatment-naive, with mild/moderate illness. It is important to understand the overall profile of the well-characterized cohort from the clinic, in the context of several research studies that have looked at various clinical, social and biological aspects in OCD.