title: An epidemological study of obsessive compulsive disorder in adolescents from India.
abstract: OBJECTIVE
  There is scarce data on the prevalence of OCD among adolescents in India. This study reports point prevalence of OCD among school students (age 12-18years) in the Kerala state of India and examines its association with ADHD, psychological distress, tobacco/alcohol abuse, suicide risk and history of sexual abuse.
  
  
  METHODS
  7560 students of 73 schools were self-administered the OCD subsection of Clinical Interview Schedule-Revised, the Composite International Diagnostic Interview (CIDI) for obsessive compulsive symptoms and other relevant instruments to identify OCD and related clinical measures. A diagnosis of ICD-10 OCD was derived through the CIS-R algorithm which required duration of at least 2weeks and at least a thought/behavior to be resisted along with a cut-off score for severity and impairment.
  
  
  RESULTS
  In the sample, 50.3% were males with a mean age of 15.2years (range of 12-18years). The response rate was 97.3% (7380 valid responses). 0.8% (n=61) fulfilled criteria for OCD with a male predominance (1.1 vs. 0.5%, p=0.005). Prevalence was higher among Muslims and increased with age. Taboo thoughts (62.3%) and mental rituals (45.9%) were the commonest symptoms. Those with OCD had significantly higher suicidal thoughts (59 vs. 16.3%, p<0.01) suicide attempts (24.6 vs. 3.8%, p<0.01), ADHD (28 vs. 4%, p<0.001), sexual abuse (24.6 vs. 4.2%, p<0.01), and tobacco use (23 vs. 6.8%, p=0.01). They also reported greater psychological distress and poorer academic performance.
  
  
  CONCLUSIONS
  OCD is common among adolescents in India. Its associations with ADHD, sexual abuse, psychological distress, poorer academic performance and suicidal behavior are additional reasons for it to be recognized and treated early.
authors.affiliation: Department of Psychiatry, Government Medical College, Ernakulam, Kerala 683503, India. Electronic address: tsjaisoorya@gmail.com.
authors.forename: T S
authors.initials: TS
authors.lastname: Jaisoorya
authors.affiliation: Department of Psychiatry, NIMHANS, Bangalore, India.
authors.forename: Y C
authors.initials: YC
authors.lastname: Janardhan Reddy
authors.affiliation: Department of Biostatistics, NIMHANS, Bangalore India.
authors.forename: K
authors.initials: K
authors.lastname: Thennarasu
authors.affiliation: National Rural Health Mission, Thiruvanthupuram, Kerala, India.
authors.forename: K V
authors.initials: KV
authors.lastname: Beena
authors.affiliation: National Rural Health Mission, Thiruvanthupuram, Kerala, India.
authors.forename: M
authors.initials: M
authors.lastname: Beena
authors.affiliation: National Rural Health Mission, Ernakulam, Kerala, India.
authors.forename: Dalia C
authors.initials: DC
authors.lastname: Jose
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D038801:International Classification of Diseases; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data