Obsessive-compulsive disorder (OCD) is a mental health condition that profoundly impacts those it affects, marked by intrusive, persistent thoughts and compulsive behaviors that can severely disrupt daily functioning. While the disorder has been extensively studied in general populations, there is a growing concern about its presence and impact among medical students, a group exposed to high levels of stress and specific environmental triggers. A groundbreaking cross-sectional study recently conducted at Dilla University in Ethiopia sheds new light on the prevalence and associated factors of obsessive-compulsive symptoms among undergraduate medical and health science students, revealing alarming rates and critical correlations that demand urgent attention.
The study, published in the latest issue of BMC Psychiatry, involved 370 students enrolled in various medical and health science disciplines. Employing the Obsessive-Compulsive Inventory-Revised scale (OCI-R), a validated psychometric tool for assessing the severity of obsessive-compulsive symptoms, the researchers were able to quantify the probable prevalence of OCD symptoms within this demographic. Their findings indicate that nearly 28% of the participants exhibited clinically significant symptoms indicative of obsessive-compulsive disorder. This figure is particularly striking given the limited recognition and research on OCD in low- and middle-income countries, particularly in sub-Saharan Africa.
One notable aspect of this study is its focus on medical students—a subgroup arguably more vulnerable due to the intense academic pressure, prolonged exposure to clinical environments, and heightened awareness of contamination risks inherent in healthcare settings. These factors can potentiate obsessive behaviors, particularly related to cleanliness and ritualistic checking, hallmark symptoms of OCD. The Dilla University study provides compelling evidence that this vulnerability translates into measurable psychiatric morbidity, emphasizing the necessity of integrating mental health support specifically tailored to medical trainees.
In addition to prevalence rates, the research highlights several significant factors associated with the manifestation of obsessive-compulsive symptoms. Female students were found to have a higher adjusted odds ratio (AOR = 1.33) of experiencing these symptoms compared to their male counterparts, aligning with global epidemiological trends that often report greater OCD prevalence in females. This gender disparity may stem from biological, psychological, and socio-cultural influences that uniquely affect women in high-pressure educational environments.
The presence of depressive symptoms was another powerful predictor of obsessive-compulsive manifestations. Students experiencing depressive symptomatology were more than twice as likely (AOR = 2.12) to suffer from obsessive-compulsive symptoms. This comorbidity is well-documented in psychiatric literature, where depression and OCD frequently co-occur, potentially exacerbating each other’s severity and complicating clinical management. The bidirectional relationship underscores the complex interplay between mood and anxiety disorders in demanding academic settings.
Maladaptive coping mechanisms also emerged as a crucial correlate. Students who relied on ineffective or harmful coping strategies were 1.74 times more likely to exhibit OCD symptoms. Maladaptive coping, which may include avoidance, denial, or substance misuse, can impair resilience and increase psychological distress, thereby fostering an environment conducive to the development or exacerbation of obsessive-compulsive symptoms. These findings advocate for the promotion of adaptive coping skills and resilience training within medical curricula.
Poor sleep quality was yet another significant factor associated with obsessive-compulsive symptoms (AOR = 1.48). Sleep disturbances are both a symptom and a risk factor for various psychiatric disorders, including OCD. In the high-stress milieu of medical education, compromised sleep can diminish cognitive functioning, emotional regulation, and stress tolerance, contributing to the induction or worsening of OCD symptoms. Crucially, this highlights an area where targeted intervention—such as sleep hygiene and stress management programs—may mitigate symptom burden.
The study’s methodology entailed rigorous data collection through the Kobo Collect Toolbox, ensuring accurate digital data entry, followed by sophisticated statistical analysis via SPSS software. Both bivariable and multivariable logistic regression analyses were conducted, accounting for potential confounders to isolate the independent effects of associated factors. This robust analytical approach strengthens confidence in the validity of the reported associations and underscores the heterogeneous profile of risk factors contributing to obsessive-compulsive symptomatology.
Given the high prevalence and associated risk factors, the study authors advocate for the implementation of early detection strategies. Routine screening for OCD symptoms in medical schools, integrated within existing mental health services, would facilitate timely identification and intervention. Such initiatives are especially vital since obsessive-compulsive symptoms are often under-recognized and under-treated in academic settings, despite their profound implications on students’ well-being and academic performance.
Furthermore, the findings call for a multi-pronged intervention approach. This includes not only the early detection and treatment of OCD but also targeted support to address comorbid depression, sleep disturbance, and maladaptive coping. Comprehensive mental health programs that promote adaptive coping mechanisms, resilience-building, and stress management could significantly alleviate the burden of psychiatric symptoms in this vulnerable population.
This research also carries broader implications for mental health policy in low- and middle-income countries (LMICs). The scarcity of data on OCD prevalence in such settings, combined with the limited availability of specialized mental health services, presents a significant challenge. By illuminating the considerable prevalence and specific contributing factors among Ethiopian medical students, this study serves as a catalyst for enhanced investment in psychiatric research and services in similar contexts.
Moreover, the study underscores the global necessity of contextualizing mental health interventions. Medical schools worldwide share common stressors, but cultural, environmental, and systemic differences impact how disorders manifest and are managed. Tailoring mental health resources to reflect these realities can optimize support and outcomes for students at risk of OCD and related psychopathologies.
In conclusion, this pioneering study from Dilla University establishes a critical foundation for understanding obsessive-compulsive symptoms in a demographic that is both vulnerable and essential to the future healthcare workforce. The revelation that nearly one-third of medical and health science students may experience clinically significant OCD symptoms is a clarion call for educators, policymakers, and mental health professionals. Effective, culturally sensitive interventions that encompass early detection, treatment of comorbidities, and enhancement of coping and sleep quality stand to greatly improve the mental health landscape for medical students in Ethiopia and beyond.
As the medical community advances knowledge on OCD in academic settings, the findings of this study offer a timely and compelling reminder that addressing mental health is not merely an individual concern but an institutional imperative. The well-being of medical students today will shape the quality of healthcare delivery tomorrow, illustrating the profound interconnectedness of mental health investment and public health success on a global scale.
Subject of Research: Prevalence and associated factors of obsessive-compulsive symptoms among undergraduate medical and health science students in Ethiopia.
Article Title: Prevalence and associated factors of obsessive compulsive symptoms among undergraduate medical and health science students in Dilla University, Ethiopia: a cross-sectional study.
Article References:
Madoro, D., Endeshaw, M., Alemwork, A. et al. Prevalence and associated factors of obsessive compulsive symptoms among undergraduate medical and health science students in Dilla university, Ethiopia: a cross-sectional study. BMC Psychiatry 25, 380 (2025). https://doi.org/10.1186/s12888-025-06833-0
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