Severity and risk factors associated with comorbid depression, anxiety, and stress in adults with obsessive-compulsive disorder in Peshawar, Pakistan
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Abstract
Objective: To examine the severity and risk factors associated with co-morbid depression, anxiety, and stress in adults with obsessive-compulsive disorder (OCD) in Peshawar, Pakistan.
Methods: This cross-sectional study was conducted from August 2022 to January 2023 at Psychiatry Department, Lady Reading Hospital, Peshawar. Through purposive sampling, 104 patients (aged 18–45 years; mean±SD = 29.15±8.18) with DSM-5 diagnosed OCD were enrolled. Severity of OCD was assessed with Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and co-morbid depression, anxiety, and stress were measured with Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using descriptive statistics, Pearson correlation, regression analysis, and odds ratios (OR) for associated risk factors at p<0.05.
Results: Among participants, 79% had co-morbid depression, 76% anxiety, and 51% stress. On Y-BOCS, 54.8% had extremely severe and 35.6% severe OCD symptoms. Depression was mostly moderate (54.8%), while anxiety was moderate (34.6%) to severe (26%), and stress was mild (33.7%) to moderate (17.3%). Y-BOCS scores showed significant positive correlation with DASS-21 depression (r=.345, p<0.01) and stress (r=.285, p<0.01). Regression analysis revealed depression (β=.247, p<0.05), anxiety (β=-.368, p<0.001), and stress (β=.397, p<0.001) as predictors of OCD severity. Significant risk factors for co-morbidities included age ≤30 years, marital status, past psychiatric history, and illness duration >1 year.
Conclusion: High rates of co-morbid depression, anxiety, and stress were observed among OCD patients, with significant associations to illness duration, marital status, and psychiatric history. These findings highlight the importance of early screening and integrated management strategies to improve treatment outcomes and quality of life in OCD patients.
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