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1 Resident, Department of Psychiatry, Institute of Postgraduate Medical Education and Research, Chandigarh, India., Resident, Department of Psychiatry, University of Virginia School of Medicine, Charlottesville, Virginia 22901, U.S.A.
2 Professor and Chairman, Department of Psychiatry, Institute of Postgraduate Medical Education and Research, Chandigarh, India
3 Associate Professor, Department of Psychiatry, Institute of Postgraduate Medical Education and Research, Chandigarh, India
4 Clinical Psychologist, Department of Psychiatry, Institute of Postgraduate Medical Education and Research, Chandigarh, India
Eighty-two obsessional neurotics were studied from a phenomenological point of view in order to delineate the various forms and contents of obsessions and compulsions. An attempt was made to ascertain the frequency with which the different forms and content occur and their effect on the final outcome of the disorder. Five types of obsessions were identified: doubts, obsessive thinking, fears, impulses, and images, in order of frequency of their occurrence. Compulsive acts could be classified in two types, depending on whether they yielded to or diverted the underlying obsession. One-fourth of the patients displayed no compulsions. The content of obsession could be classified in five broad categories as relating to: dirt and contamination, aggression, inanimate-impersonal themes, religion, and sexual matters, in order of the frequency of their occurrence. The paper, while offering an interpretation of these findings, emphasizes the part played by socio-cultural factors in the character of an obsession's thought content.
The absence of compulsions was found to be associated with good prognosis. A downward gradient was noted in the final outcome of patients without compulsions, those with controlling compulsions alone, those with both varieties of compulsions, and those displaying yielding compulsions alone, in that order. Based on this observation the paper suggests a prognosis-related hierarchical continuum of the severity of obsessional disorder.
Submitted on August 29, 1974
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