ABSTRACT
Background:
Obsessive–compulsive disorder (OCD) is a psychiatric condition characterized by unwanted thoughts (obsessions) and repetitive behaviors (compulsions). Medical undergraduates are at higher risk of developing OCD due to academic stress and the need for precision in patient care. This study aimed to assess the prevalence and correlates of OCD symptoms among medical students.
Methods:
A cross-sectional study was conducted from March 2022 to June 2022 among 640 medical undergraduates at a tertiary care institute in Secunderabad, Telangana, India. Data were collected using the Obsessive–Compulsive Inventory–Revised (OCI-R) scale, with a score of ≥21 considered as indicative of probable OCD. Statistical analysis was performed using SPSS version 21 with significance set at P < 0.05.
Results:
The mean age of participants was 20.8 ± 1.5 years, with a female predominance (61.2%). A probable OCD prevalence of 29.1% was observed. Younger age (≤20 years), female gender, first and second academic years, and a family history of OCD were significantly associated with higher OCD symptoms (P < 0.01). Body dysmorphia (26.1%) was the most common associated spectrum disorder. A weak negative correlation (r = −0.28) was noted between OCD severity and academic performance.
Conclusion:
OCD symptoms were notably prevalent among medical students, highlighting the need for early screening, mental health support, and stigma reduction initiatives within medical colleges to promote overall well-being.
KEYWORDS: Body dysmorphia, medical students, mental health, obsessive–compulsive disorder, psychiatry disorders
INTRODUCTION
Obsessive–compulsive disorder (OCD) is a chronic psychiatric condition characterized by unwanted thoughts (obsessions) and repetitive actions (compulsions) that individuals feel driven to perform.[1] These symptoms often begin during adolescence and may go unnoticed. Among medical students, the risk of developing OCD is higher due to the stressful academic curriculum, the need for precision in skills, and constant exposure to competitive environments.[2] Studies have shown varied prevalence rates of OCD among medical students worldwide, ranging from as low as 3.8% to as high as 43%. Common symptoms include obsessions related to cleanliness, checking, fears of negative events, and body dysmorphic concerns.[3] Given the significant academic and emotional burden posed by untreated OCD, early identification and intervention among medical undergraduates is crucial.[4] Hence, this study aimed to assess the prevalence of probable OCD symptoms and associated factors among medical students in Secunderabad, Telangana, India.
MATERIAL AND METHODS
A cross-sectional study was conducted in the Department of Community Medicine at a public tertiary care institute in Secunderabad, Telangana, India, among MBBS undergraduate students. The study was carried out over four months from March 2022 to June 2022. The sample size was calculated using the formula n = Z²pq/d², assuming a prevalence of 43.2% from previous literature, resulting in a required sample size of 510; however, 640 students from all academic years participated after informed consent. Students who were absent after two extra attempts of data collection were excluded. Data were collected using a pre-designed, pre-tested Obsessive-Compulsive Inventory–Revised (OCI-R) questionnaire in English, a self-reported scale with 18 items across six subscales: washing, obsessing, ordering, checking, neutralizing, and hoarding. A score of ≥21 on the OCI-R was considered indicative of probable OCD. Sociodemographic details, such as age, gender, academic year, and family history of OCD, were also recorded. Data were entered into MS Excel and analyzed using SPSS version 21. Descriptive statistics were expressed in percentages, and Chi-square tests were used to identify significant associations, with a P value of < 0.05 considered statistically significant. Ethical approval (RC. No. IEC/GMC/2022/03/42) was obtained from the Institutional Ethics Committee, and confidentiality of participants was strictly maintained using anonymized data sheets.
RESULTS
A total of 640 undergraduate medical students participated in the study, with a mean age of 20.8 ± 1.5 years and a female predominance of 61.2%. Probable OCD symptoms were observed in 29.1% of students, with significant associations noted between OCD symptoms and younger age, female gender, earlier academic years, and family history of OCD.
Table 1 shows the distribution of study participants according to the presence or absence of probable OCD symptoms, showing that 29.1% had probable OCD as per the OCI-R scale.
Table 1.
Distribution of study subjects as per the presence of probable OCD symptoms
| OCD status | Frequency (n) | Percentage (%) |
|---|---|---|
| No OCD | 454 | 70.9% |
| Probable OCD | 186 | 29.1% |
| Total | 640 | 100% |
Table 2 highlights the distribution of study participants across different age groups, with maximum representation in the 18–20 years age group.
Table 2.
Age-wise distribution of study participants
| Age (Years) | Frequency (n) | Percentage (%) |
|---|---|---|
| 17 | 34 | 5.3% |
| 18 | 209 | 32.7% |
| 19 | 157 | 24.5% |
| 20 | 166 | 26.0% |
| 21 | 59 | 9.2% |
| 22 | 15 | 2.3% |
| Total | 640 | 100% |
Table 3 depicts the association of probable OCD symptoms with demographic variables, showing significant correlation with younger age, female gender, early academic years, and family history of OCD.
Table 3.
Correlation of probable OCD symptoms with demographic variables
| Variables | Probable OCD n (%) | Normal n (%) | P |
|---|---|---|---|
| ≤20 years (n=566) | 172 (30.3%) | 394 (69.7%) | <0.05 |
| >20 years (n=74) | 14 (18.9%) | 60 (81.1%) | |
| Male (n=249) | 49 (19.4%) | 200 (80.6%) | <0.01 |
| Female (n=391) | 137 (35.1%) | 254 (64.9%) | |
| 1st and 2nd professional years (n=300) | 112 (37.4%) | 188 (62.6%) | <0.01 |
| 3rd and 4th professional years (n=340) | 74 (21.6%) | 266 (78.4%) | |
| Family history of OCD present (n=90) | 48 (53.8%) | 42 (46.2%) | <0.01 |
| Family history of OCD absent (n=550) | 138 (25.0%) | 412 (75.0%) |
Table 4 shows the distribution of associated OCD spectrum disorders among study participants, with body dysmorphia being the most common.
Table 4.
Distribution of OCD spectrum disorders among study participants
| Associated spectrum disorder | Frequency (n) | Percentage (%) |
|---|---|---|
| Body dysmorphia | 167 | 26.1% |
| Hypochondriac | 134 | 20.9% |
| Depressive symptoms | 110 | 17.2% |
Table 5 highlights the reasons for not seeking professional mental health support among students with probable OCD, identifying stigma as the most cited barrier.
Table 5.
Reasons for not seeking professional mental health support among students with probable OCD
| Reason | Frequency (%) |
|---|---|
| Stigma | 41% |
| Lack of awareness of services | 18% |
| Lack of time | 15% |
| Ignorance of the condition | 26% |
DISCUSSION
The present study highlights a notable prevalence of probable obsessive–compulsive disorder (OCD) symptoms (29.1%). The findings indicate higher OCD prevalence among younger students, particularly females, and those in early academic years.[5] Body dysmorphia emerged as the most common associated spectrum disorder, emphasizing the influence of social and academic pressures on self-image. A weak negative correlation between OCD severity and academic performance was observed, suggesting mild academic impairment among affected students.[6] Notably, stigma, lack of awareness, and time constraints were major barriers preventing students from seeking mental health support. Compared to global literature, the observed prevalence falls within the mid-range, higher than studies from Brazil but lower than reports from Iraq and Tamil Nadu.[7] These findings underscore the urgent need for early screening programs, mental health promotion activities, and stigma reduction strategies within medical institutions.[8]
CONCLUSION
OCD symptoms were found to be significantly prevalent among medical undergraduates, particularly among younger students, females, and those in early academic years. Early screening, mental health support initiatives, and stigma reduction measures are essential to safeguard the psychological well-being of future healthcare professionals.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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