Assessment of Mental Disability using Indian Disability Evaluation Assessment Scale in Obsessive Compulsive Disorder and Dysthymic Disorder VC21-VC23
Dr. Sathish SV Kumar,
Senior Resident, Department of Psychiatry, Kodagu Institute of Medical Sciences, Madikeri-571201, Karnataka, India.
Introduction: Obsessive Compulsive Disorder (OCD) is characterised by recurrent obsessions or compulsions that are severe enough to be time-consuming or cause marked distress or significant impairment and is given disability benefits as per the existing Indian disability act. Dysthymic Disorder (DD) is a chronically depressed mood that occurs for most of the day, more days than not for at least two years and may also lead to disability for which benefits are not given. In view of limited research and the paucity of data, the current study was conducted to address these lacunae.
Aim: To assess mental disability in OCD and compare it with DD for benefits under the Indian disability Act.
Materials and Methods: The present study was a cross-sectional hospital-based comparison study conducted in two group of 30 patients each diagnosed to have OCD and DD during October 2009 to September 2011 in a medical institution in Karnataka, India. Diagnostic and Statistical Manual of Mental disorders (DSM)-IV criteria were used for diagnosis of OCD and DD. Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HAM-D) and Indian Disability Evaluation and Assessment Scale (IDEAS) were used. Statistical Package for Social Sciences (SPSS) version-16.0 software was used for analysis. For continuous data, studentâ€™s t-test and for categorical data, â€˜chi-square testâ€™ was used respectively.
Results: The mean disability score was 6.39 (SD=1.5) and 6.13 (SD=1.14) in OCD and DD respectively. Disability score was not found to be different within the various groups, of socio-demographic parameters like age, sex, occupation, residence education, socioeconomic status in OCD and DD conditions. The percentage of moderately disabled patients were more in the DD group (53.3%) than in the OCD group (36.7%). In the domain of self-care and duration of illness, there was a significant difference between the OCD and DD group (p<0.05). Mild (n=19) and moderate (n=11) disability in obsession and compulsion categories showed no statistical significance.
Conclusion: Disability in DD was similar to that of OCD as total disability score had no significant difference between the two groups. However, further research is needed to assess the extent of disability in non-psychotic disorders for disability benefits.