Gender Difference in Major Depression and Generalized Anxiety Disorder Comorbidity in Patients of Obsessive Compulsive Disorder

Context: Obsessive Compulsive Disorder is a disease with controversies regarding co-morbidities. Studies have noted there are some doubts due to the disease's heterogeneity and cultural influence. Some studies have reflected that women are more likely to have Major depressive disorder(MDD) as co-morbidity while the impact of gender on co-morbid generalized anxiety disorder(GAD) was inconclusive. There are few Indian studies in this regard and hence this cross-sectional study was performed in a tertiary referral centre in Eastern India.

Material and method: 100 consecutive eligible patients with OCD(Male=41,Female=59) were interviewed. The data were recorded for socio-demographic profile, depression and anxiety comorbidities.

Results: The mean age of the study sample was 32.73 yrs, mostly from rural background(82%) and nuclear families (62%).The subjects were found to be suffering mostly from co-morbid MDD(85%) and GAD(83%).93% of our female subjects had co-morbid MDD while 90% of them had co-morbid GAD. The corresponding percentages for 41 males was 73%(for both MDD and GAD). Gender had an impact on both these co-morbid diagnoses(P-value<0.05)though the association with depression was more.

Conclusion: Our study showed both MDD and GAD were highly comorbid with OCD and gender(i.e female sex) having influence on diagnosis. This may be due to long-term suppression&underreporting of our patients due to the taboo of suchi-bai,distress caused by this suppression and denial in family life and the female majority.

Recommendations: 1)Early diagnosis and prompt management of MDD and GAD in female OCD subjects to reduce morbidity. 2) Further longitudinal community-based studies.