Living with obsessive-compulsive disorder (OCD): a South African narrative

Abstract

BackgroundObsessive–compulsive disorder (OCD) is a highly prevalent and debilitating psychiatric disorder known to interfere with several life domains. Yet little is known about the subjective experiences of living with OCD amongst South Africans and more so, the ways in which it impacts daily functioning and quality of life (QOL).MethodsThe aim of this study was to explore daily functioning and QOL among South African adults living with OCD. Qualitative semi-structured interviews were conducted with 20 adults with a primary diagnosis of OCD. We used ATLAS.ti v7 to analyse the data, thematically. The study was conducted at the SU/UCT MRC Unit on Risk and Resilience in Mental Disorders in South Africa.ResultsThree key themes were identified namely, (1) realisation of OCD, (2) disruptions to daily life and (3) managing the disruptions to daily life. Participants recounted their earliest recollections of OCD, the instances when they recognised something was wrong and ways in which they came to terms with their OCD. Disruptions to daily life included poor sleep quality, inability to enjoy leisure activities which impacted on socialisation and impairment in school/work performance. Perceived social support from family members, friends and colleagues were invaluable to helping participants manage these disruptions. Further, strategies such as self-talk, diary-keeping and humour helped them cope.ConclusionWhile some individuals with OCD have found ways to cope with and accept having OCD, all participants perceived their QOL to be significantly reduced and their functioning impaired due to the condition, on multiple levels. The importance of acceptance in OCD ties in with research on the potential value of Acceptance and Commitment Therapy, which could form an adjunct to more conventional techniques such as Cognitive-Behavioural Therapy. The themes emanating from this study can be used to help clinicians better understand what treatment works best for patients with OCD—and whether this treatment be focused on the individual or together with close members of their microsystem, such as spouses/partners. Further these findings may potentially help to improve access, affordability and the quality of life of South Africans living with OCD from various income backgrounds.

Lived experiences of children and adolescents with obsessive–compulsive disorder: interpretative phenomenological analysis

“…signs of OCD' reported in a study by Keyes et al [22]. 'Recognising something's wrong' and 'coming to terms with OCD' are two sub-ordinate themes under the major theme of 'realisation of OCD' elucidated by Kohler, Coetzee and Lochner [35]. These correspond to the subthemes of 'clarity sinks in and battle ensues' and 'grief and acceptance' of the current study.…”

“…These correspond to the subthemes of 'clarity sinks in and battle ensues' and 'grief and acceptance' of the current study. It is important to note that they have not been described in relation to time in the previous study by Kohler, Coetzee and Lochner [35].…”

“…However, the sub-theme 'victim of bullying and social misperceptions' under 'cascading effects of OCD' refers to bullying occurring in the aftermath of OCD. Kohler, Coetzee and Lochner described an overarching theme 'disruptions to daily life' that encompassed sub-ordinate themes of 'disruptions in sleep and rest' , 'disruptions to leisure activities and hobbies' and 'disruptions to productivity [35]. The present study had 'disruptions in sense of self ' as one of the sub-themes.…”

“…Most of the qualitative research on OCD has been done in adult participants. It is focused on exploring subjective experiences [13,14,[34][35][36][37][38][39][40][41][42], reassurance seeking [43,44], enablers and barriers [45], stigma and labeling [46], family members perceptions [47], impact on partner relationships [48] and user perspectives on interventions [49][50][51][52][53][54]. The sample size in these studies varied depending on the methodology that varied from case study to ethnographic approaches.…”

Medication management in the context of mental illness: an exploratory study of young people living in Australia

“…While this is a key study limitation, the research team were cognisant of the vulnerabilities of the population they were interviewing and wished to do what they reasonably could to maximise their anonymity. As only single, one-off, interviews were conducted, opportunities for the researchers to build rapport with participants were limited [60] and therefore, not all relevant information may have been obtained. Participants, while representing a variety of life experiences, were mostly female and Caucasian (although this information was not confirmed by asking participants to provide broader demographic details such as sexual orientation, ethnicity etc.)…”