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LETTER TO THE EDITOR
Year : 2022  |  Volume : 15  |  Issue : 5  |  Page : 824-825  

Mental contamination as a core symptom of obsessive–Compulsive disorder


Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India

Date of Submission10-Jul-2021
Date of Decision11-Jul-2021
Date of Acceptance12-Jul-2021
Date of Web Publication28-Jan-2022

Correspondence Address:
Dr. Suprakash Chaudhury
Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_552_21

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How to cite this article:
Kolagani R, Kadiani A, Chaudhury S, Saldanha D. Mental contamination as a core symptom of obsessive–Compulsive disorder. Med J DY Patil Vidyapeeth 2022;15:824-5

How to cite this URL:
Kolagani R, Kadiani A, Chaudhury S, Saldanha D. Mental contamination as a core symptom of obsessive–Compulsive disorder. Med J DY Patil Vidyapeeth [serial online] 2022 [cited 2022 Dec 10];15:824-5. Available from: https://www.mjdrdypv.org/text.asp?2022/15/5/0/336825



Dear Sir,

Obsessive–compulsive disorder (OCD) as it is popularly called is a disorder in which recurring, unwanted thoughts, ideas, or sensations (obsessions) makes one to do something repetitively, i.e., compulsions. Mental contamination is one such symptom in which an individual feels dirty or impure even without having to come into direct contact with a contaminated object. Mental contamination is defined as a feeling of contamination arising from a mental event. There may be association between unwanted thoughts having to do with feeling dirty/contaminated and other types of unacceptable, immoral, repugnant thoughts, and related cognitions. We present a case of mental contamination as a core symptom in OCD.

A 44-year-old married male, working as a tailor, hailing from a suburban background, presented with a 10 years' history of repeated thoughts about contamination and compulsive acts of cleaning. This was accompanied by headache, palpitation, sleep disturbance on and off with impairment in day-to-day functioning. Onset was insidious and progressive in nature following a stressful life event (Suicide). There was no history to suggest psychosis or organicity. Family history of completed suicide in his elder sister was noted. Premorbidly, he was reported to have anankastic traits. On mental status examination, general appearance was appropriate, talk was relevant and coherent, thoughts of mental contamination and contact contamination as obsession and immediate compulsive act with cleansing himself by washing his hands and taking a bath to relieve anxiety caused by the obsessive thoughts of contamination was present. The patient was aware that his compulsive acts are senseless and consumed a lot of time. No perceptual abnormality was reported. Memory, orientation, and insight were unimpaired. He was started on fluoxitine 20 mg and the daily dose was up titrated to 60 mg and along with cognitive behavioral therapy (CBT) he achieved partial remission in 6 months, and a near-total improvement in 1 year.

The feelings of mental contamination can be evoked by memories, images, thoughts, and impulses.[1],[2] Patient's above symptom of mental contamination was a core obsessive symptom of a long duration. Thoughts of contamination were associated with persons/memories associated with them rather than fear of getting infected. These thoughts were generated by intrusive disturbing memories, followed by distress and compulsive behavior.[3] Identifying this phenomenon helps in appropriate focus in therapy. Mental contamination in OCD patients can be treated effectively with anti-obsessive medications along with CBT. CBT works by altering the meaning or understanding of obsessive intrusive thoughts, and as a result, they are no longer seen as detrimental. Consequently, the frequency of compulsive washing behaviors also reduces.[4]

The identification of core symptom in OCD is an important step in the success of reducing the mental agony and eventual success in the treatment as enumerated in the above case.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Radomsky AS, Coughtrey A, Shafran R, Rachman S. Abnormal and normal mental contamination. J Obsessive Compuls Relat Disord 2018;17:46-51.  Back to cited text no. 1
    
2.
Poli A, Melli G, Radomsky AS. Different disgust domains specifically relate to mental and contact contamination fear in obsessive-compulsive disorder: Evidence from a path analytic model in an Italian clinical sample. Behav Ther 2019;50:380-94.  Back to cited text no. 2
    
3.
Coughtrey AE, Shafran R, Knibbs D, Rachman SJ. Mental contamination in obsessive–compulsive disorder. J Obsessive Compuls Relat Disord 2012;1:244-50.  Back to cited text no. 3
    
4.
Coughtry A, Booker E. Mental Contamination in Obsessive-Compulsive Disorder. Oxford Clinical Psychology, 2021. Available from: https://www.oxfordclinicalpsych.com/page/mental-contamination-ocd. [Last accessed 2021 Jul 09].  Back to cited text no. 4
    




 

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