Assessment of the Prevalence and Types of Mental Compulsions in Patients With Obsessive-Compulsive Disorder in North Karnataka: A Cross-Sectional Study.

Background: Obsessive-compulsive disorder (OCD) is a significant mental condition characterized by the presence of obsessions and compulsions. Mental compulsions are defined as compulsions with no overt behavioral or motoric symptoms, such as repeating certain words or phrases in the mind. The exact prevalence of mental compulsions could be underestimated due to measurement issues using the Y-BOCS (Yale-Brown Obsessive Compulsive Scale) and its clinical characteristics. They are a more chronic and severe form of OCD and respond poorly to cognitive behavioral therapy. Given the relatively high prevalence of mental compulsions, the limited research on their phenomenology and clinical correlations, and the potentially significant implications for treatment, further research is needed.

Methodology: This cross-sectional study was carried out after obtaining the institutional ethical committee clearance of Bijapur Lingayat District Education (BLDE) (Deemed to be University) Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura. People in the age group of 10 to 60 years with a diagnosis of OCD were assessed for symptom profiles using the dimensional Y-BOCS (DY-BOCS) and a mental compulsions checklist.

Results: In a sample of 80 participants with OCD, the overall point prevalence of mental compulsions in patients with OCD was 53.75% (n=43). Most of these patients had behavioral compulsions as well. Among 43 patients having mental compulsions, obsessions about sacrilege and blasphemy were most common (35%), followed by obsessions related to symmetry (32%). The most common mental compulsions were undoing "bad" thoughts with "good" thoughts (51%), followed by praying (40%) and reassuring themselves (32%).

Conclusions: Mental compulsions were present in over 50% of the study population. They were the most prevalent, following religious, symmetry, and harm-related obsessions. Most of the patients had multiple mental compulsions. The most common types were undoing bad thoughts with good thoughts, followed by praying, reassuring themselves, and repeating phrases or mantras.