Rasika Karkare 
Obsessive Compulsive Disorder (OCD) is a mental health condition characterized by consistent and unwanted intrusive thoughts (obsessions). These obsessions often lead to anxiety, prompting people to engage in repetitive patterns of behaviours known as compulsions. OCD is a common disorder, that impacts millions of people around the world. In fact, research suggests that almost 1 in 40 adults in the US suffers from OCD.
In this article, we are going to explore the statistical prevalence of OCD in India, whether OCD can be inherited from parents, and the impact of OCD on IQ and cognitive functioning.
The Prevalence Of OCD in India
OCD in India
There has been limited research on the prevalence of OCD in India. However, the data from the National Mental Health Survey (NMHS) conducted in 2016 suggests that almost 0.6% of Indians suffer from some form of OCD. However, newer data suggests that the prevalence of OCD in India can be as high as 2 to 3.3%, but additional research may be required to validate these claims.
OCD in Children And Adolescents in India
The prevalence of OCD among children in India hasn't been subject to a lot of research. However, the findings with limited research have been interesting.
A study was conducted in 2015 in schools of Kerela to investigate the prevalence of OCD among adolescents aged 12-18 years. This study included almost 7,500+ students from 73 schools in Kerela. Based on the study, researchers found that the prevalence of OCD among adults was 0.8% The researchers also found that the prevalence of OCD was higher among males as compared to females and OCD symptoms were likely to increase with age. Additionally, the research also found that adolescents with OCD were also likely to have ADHD and other issues such as stress and poor academic performance.
Another study conducted in 2022 studied the clinical profile of children with OCD aged below 12 years and found that the onset of OCD can be as early as 6 years of age. The research also found that almost 50% of children diagnosed with OCD had a family member with OCD or another mental health condition. Another significant finding was that OCD can be comorbid with tic disorder, depression or conduct disorder.
OCD in Adults in India
A study conducted in 2017 among college students in Kerela suggested that the prevalence of OCD among college students aged 18-25 was 3.3%. The research also found that the prevalence of OCD was slightly higher in males (3.5%) as compared to females (3.2%). The most common symptoms of OCD in the population of 5784 students were mental rituals and taboo thoughts. Additionally, the study also found that students with OCD had higher rates of psychological stress, tobacco use suicidality and sexual abuse, along with higher scores in ADHD symptoms, suggesting comorbidity.
Another study conducted in West Bengal in 2016 investigated the socio-cultural differences among OCD patients. The research concluded that there were no significant differences in the OCS scores of rural, semi-rural or urban populations. However, an interesting finding was that most of the rural and semi-rural populations fell under severe' OCD scores, while the urban population had 'extreme' OCD scores.
Additionally, a 2023 article published in 'The Times of India' reported that there was significant growth in mental-health consultations for OCD, particularly after the pandemic, Most of these consultations were taken by people between the ages of 13-35 years, suggesting that OCD is on the rise in the country.
In summary, OCD seems to be one of the less studied conditions, leading to limited research and data about its exact statistics in India. However, the available data is enough to provide evidence that OCD may be on the rise in India, affecting all populations, from children to adults. OCD also seems to be comorbid with other conditions, such as ADHD and substance use. Overall, the current data indicates that more research and awareness are required to chart the exact prevalence of OCD in India.
Is OCD Inherited From Father Or Mother?
While the exact cause of OCD is still unknown, research suggests that genetics can play a crucial role in OCD. But can you inherit OCD from your father or mother? Let's find out.
OCD and Genetics
Multiple research studies suggest that OCD has a strong genetic component, which means, there is a high risk of a child developing OCD if someone from the family already has it.
A literature review conducted in 2014 suggests that OCD is more common in relatives of people with OCD, suggesting that OCD has a strong genetic component. The research also suggests that the risk of OCD increases if first-degree relatives (siblings, father or mothers) are already diagnosed with the condition, indicating that there is indeed a higher risk of OCD for a child if one of their parents already has the condition. The research further stated that OCD can co-occur with other conditions, such as body dysmorphic disorder and tic disorders, more often in families, suggesting some shared genetic risk.
Additionally, multiple research studies have found that identical twins (sharing all genes) are more likely to both have OCD than fraternal twins (sharing 50% of genes), suggesting that OCD risk can increase if a sibling has the condition as well, Further, twin studies have estimated the heritability of OCD to be between 27% and 65%, suggesting a strong genetic link.
Research from 2013 investigating the role of genetics in OCD came to a similar conclusion, where it was found that having a close relative (father, mother or siblings) with the disorder significantly increases your own risk. Additionally, maternal age over 35 is also a risk factor for OCD.
A 2020 study had similar findings, where it was found that close relatives (parents, children, siblings, twins) of people with OCD are at an increased risk of developing not only OCD itself but also a range of other mental health conditions such as schizophrenia, ADHD, etc. Additionally, the study also found that the more relatives are diagnosed with OCD in the family, the higher the risk of other family members developing the condition as well, again pointing towards the role of genetics in OCD.
Thus, research suggests that OCD can be inherited not only from a father or mother but also through twin siblings. However, it is important to note that genetics are not the only factor in OCD, as the environment plays a crucial role as well. Let's look at the environmental causes of OCD as we move ahead.
Environmental Influences In OCD
OCD is a complex disorder and like many other mental health conditions, it also develops from a complex interplay between genetics and the environment. Some environmental factors influencing OCD are:
- Traumatic life events such as the death of a loved one, divorce, and school difficulties can lead to the onset of OCD, especially for those who are already genetically predisposed to the condition.
- A childhood history of abuse also increases the risk of OCD.
- Other comorbid conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), Tourettes Syndrome, Depression and Generalized Anxiety disorder, can also increase a person's risk of developing OCD.
- Additionally, maternal health, smoking during pregnancy or infections after birth can also increase the risk of OCD.
- Lastly, low levels of serotonin, a mood-regulating neurotransmitter, can also increase the risk of OCD.
In summary, OCD can be inherited from one's father, mother or siblings. However, research suggests that parents having OCD only increases a child's risk of developing the condition, but it doesn't guarantee that the child will develop OCD. So, a child whose parents have OCD may not develop OCD at all. Additionally, environmental triggers such as traumatic events, abuse, etc also play a crucial role in the risk of OCD. Traumatic life events may lead someone to develop OCD without any family history of the condition. Thus, the environment and genetics are both significant contributors to OCD.
Can OCD Lower IQ?
The obsessions and compulsions of OCD can be distressing, impacting the person's daily functioning. But does OCD impact an individual's intelligence as well? The answer to this question is quite complex. While some research suggests that people with OCD may have lower IQ, other research suggests that OCD may impact only certain cognitive functions. Let's look at the impact of OCD on IQ in depth.
The Relationship Between OCD and IQ
OCD and IQ share a complicated relationship, to say the least. There are studies to suggest that people with OCD may have lower IQs than those who don't, while there have also been claims that OCD may be an indication of superior IQ. However, this notion has been debunked by research. That being said, research has found that OCD can disrupt various cognitive functions involving processing, attention and memory.
Research on OCD and IQ
A meta-analysis was conducted in 2017 to study if people with OCD have higher IQs as compared to people without OCD. The study found that people with OCD have an average or slightly lower IQ in comparison with others. The study also found that people with OCD may struggle with tasks related to problem-solving and visual-spatial memory as they are likely to have a lower performance IQ (PIQ). These findings indicate that OCD may lead to cognitive deficits.
Another meta-analysis published in 2020 analysed 108 studies on OCD and IQ. These studies involved more than 6,000 people with OCD. Post-analysis, the researchers found people with OCD had significantly lower IQs than people without OCD, suggesting that OCD may indeed influence IQ.
Another study from 2020 had findings that contradict the above research studies. These researchers studied the intelligence of 82 children and adolescents with OCD in comparison with children without OCD and found that children with OCD are likely to have average IQ in comparison with other children, suggesting that youth with OCD do not have major intellectual deficiencies.
OCD and It's Impact On Cognitive Functioning
In a study published in 2020, it was found that people with OCD had performance deficits in tasks that involved memory, thus they are likely to have delayed memory. The research also found that people with OCD are likely to struggle with attention, response prevention and switching between different tasks (alteration learning). However, researchers also found that people with OCD have good executive function, which suggests that they are likely to do well in tasks that need planning, decision making and verbal fluency.
While recent research may suggest that people with OCD may have good executive function, previous research published in 2013 had contradictory findings. The research in 2013 found that people with OCD are likely to struggle with tasks such as planning and decision-making due to lowered executive functioning. They may also have deficits in visual memory, making it difficult for them to remember complex visual information However, the impact of these cognitive difficulties on OCD patients is generally moderate. In conclusion, the researchers advocated for further studies to validate and reaffirm these findings.
In summary, there are various contradicting reports on the impact of OCD on IQ. While some studies suggest that people with OCD have lower IQs, other studies suggest that people with OCD may have average IQs. However, there are multiple studies to suggest that OCD may cause some cognitive deficits related to impulse control, attention and memory. In the end, it is important to know that the impact of OCD can be managed through medication and therapy, so OCD does not have to stop individuals from living their lives to the fullest.
References
Abramovitch, A., Anholt, G., Raveh-Gottfried, S., Hamo, N., & Abramowitz, J. S. (2018). Meta-analysis of intelligence quotient (IQ) in obsessive-compulsive disorder. Neuropsychology Review, 28(1), 111–120. https://doi.org/10.1007/s11065-017-9358-0
Aycicegi, A., Dinn, W. M., Harris, C. L., & Erkmen, H. (2003). Neuropsychological function in obsessive-compulsive disorder: Effects of comorbid conditions on task performance. European Psychiatry, 18(5), 241–248. https://doi.org/10.1016/S0924-9338(03)00065-8
Batistuzzo, M. C., de Marco e Souza, M., Bernardes, E. T., Requena, G., Miguel, E. C., & Shavitt, R. G. (2020). Intelligence quotient (IQ) in pediatric patients with obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 26, 100548. https://doi.org/10.1016/j.jocrd.2020.100548
Browne, H. A., Gair, S. L., Scharf, J. M., & Grice, D. E. (2014). Genetics of obsessive-compulsive disorder and related disorders. The Psychiatric Clinics of North America, 37(3), 319–335. https://doi.org/10.1016/j.psc.2014.06.002
Hu, L., Hao, Y., Liu, S., Kang, H., Qin, L., Zeng, Z., Abdelrahim, M. E. A., & Tan, Y. (2020). Intelligence quotient level and treatment of obsessive-compulsive disorders: Meta-analyses. Medical Hypotheses, 144, 109995. https://doi.org/10.1016/j.mehy.2020.109995
Increasing cases of OCD and hypochondria worry experts. (2023, June 27). The Times of India. https://timesofindia.indiatimes.com/city/patna/increasing-cases-of-ocd-andhypochondria-worry-experts/articleshow/101294005.cms
Jaisoorya, T. S., Janardhan Reddy, Y. C., Nair, B. S., Rani, A., Menon, P. G., Revamma, M., Jeevan, C. R., Radhakrishnan, K. S., Jose, V., & Thennarasu, K. (2017). Prevalence and correlates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder among college students in Kerala, India. Indian Journal of Psychiatry, 59(1), 56–62. https://doi.org/10.4103/0019-5545.204438
Pauls, D. L. (2010). The genetics of obsessive-compulsive disorder: A review. Dialogues in Clinical Neuroscience, 12(2), 149–163.
Rajith, R. K., & Krishnakumar, P. (2022). Clinical profile of obsessive-compulsive disorder in children. Journal of Family Medicine and Primary Care, 11(1), 251. https://doi.org/10.4103/jfmpc.jfmpc_1328_21
Reddy, Y. C. J., Rao, N. P., & Khanna, S. (2010). An overview of Indian research in obsessive compulsive disorder. Indian Journal of Psychiatry, 52(Suppl1), S200–S209. https://doi.org/10.4103/0019-5545.69233
Rima Das, & Souvik Raychaudhuri. (2016). A study on patients with obsessive compulsive disorder from urban, semi-rural and rural areas of West Bengal. International Journal of Indian Psychology, 3(4). https://doi.org/10.25215/0304.086
Shin, N. Y., Lee, T. Y., Kim, E., & Kwon, J. S. (2014). Cognitive functioning in obsessive-compulsive disorder: A meta-analysis. Psychological Medicine, 44(6), 1121–1130. https://doi.org/10.1017/S0033291713001803
Steinhausen, H. C., Bisgaard, C., Munk-Jørgensen, P., & Helenius, D. (2013). Family aggregation and risk factors of obsessive–compulsive disorders in a nationwide three-generation study. Depression and Anxiety. https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22163
An epidemiological study of obsessive compulsive disorder in adolescents from India. (n.d.). ScienceDirect. Retrieved June 24, 2024, from https://www.sciencedirect.com/science/article/abs/pii/S0010440X1500067X
Familial coaggregation of major psychiatric disorders among first-degree relatives of patients with obsessive-compulsive disorder: A nationwide study. (n.d.). Psychological Medicine, Cambridge Core. Retrieved June 26, 2024, from https://www.cambridge.org/core/journals/psychological-medicine/article/abs/familial-coaggregation-of-major-psychiatric-disorders-among-firstdegree-relatives-of-patients-with-obsessivecompulsive-disorder-a-nationwide-study/93D3BB33B06F84288E5A5EF2B580A7C5
Maternal effects as causes of risk for obsessive-compulsive disorder. (n.d.). PMC. Retrieved June 26, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023336/
What causes OCD? (n.d.). Verywell Health. Retrieved June 26, 2024, from https://www.verywellhealth.com/causes-of-ocd-5224817
Why genes are only a piece of the OCD puzzle. (n.d.). Verywell Mind. Retrieved June 26, 2024, from https://www.verywellmind.com/ocd-and-genetics-2510481