A Singapore study of obsessive compulsive disorder

This is a study of 283 consecutive patients diagnosed as suffering from obsessive compulsive disorder (OCD) who had sought treatment in a private psychiatric clinic. This represents 4.5% of all patients treated in the clinic. Ninety-four percent were Chinese, 3% were Indians and 0.4% were Malays. The mean age of onset of illness was 27, SD 11.9. Fifty-one percent of patients developed their illness prior to age 25. There were more male than female patients. The male to female ratio was 1.4:1. A high percentage of patients had attained higher educational level and were economically active. The main forms of the obsession were idea, impulse and image; and the main contents were contamination, illness, aggression, exactness, sex, death and religion. The main compulsions were cleaning, checking, repetitive behaviour, need for symmetry and precision and hoarding. The co-morbidity diagnoses were depressive, general anxiety, phobia, panic and psychotic disorder. In the patients who were followed-up for more than one year, it was found that 78% improved with treatment given. However, 22% remained unwell or deteriorated. In this series, it was noted that 17% of patients were severely incapacitated by the illness. Six percent had admission to mental hospital and 1% (3 cases) committed suicide.