Trauma Precursors of Obsessive Compulsive Disorder - A Case Series

Abstract

Introduction: Traumatic events are a precursor for not only post traumatic stress disorder but also obsessive compulsive disorder, which tend to have a generally better outcome and response to interventions. Such cases have not been described from an Indian sub-continental background. Methods: This case series of 19 patients were collected by a single clinician at a Trauma Focused Outpatient Clinic over a number of years through semi-structured clinical assessments and structured evaluation of traumatic events (Life Events Check List) and severity of obsessive compulsive disorders (Yale Brown obsessive compulsive scale) followed by interventions. Discussion: During assessment there was a common occurrence of past traumatic events following the initial presentation with predominantly obsessive compulsive symptoms in a diverse population representative of the Indian sub-continental background. Death due to a sudden unnatural cause was the most common traumatic events repre-senting this case series. The vignettes illustrate a clinical need to explore traumatic events that may not be revealed at the outset of the assessment. Conclusion: The case series provides clinical illustration to the construct of delayed type of post traumatic obsessive compulsive disorder in a predominantly non-western population. exploring trauma that occurred months earlier to the presentation of OCD may provide an aetiological substrate to the occurrence of OCD and may inform clinical approaches that are broader than conventional medication treatments for OCD.