OCD

Patient information booklet

Dr. Y.C.Janardhan Reddy

Dr. Sumant Khanna
Dr. Suresh Bada Math
Dr. Ravi Philiph Rajkumar
National Institute of Mental Health and Neuro Sciences

Dr.Y.C.Janardhan Reddy. DPM, MD

Additional Professor of Psychiatry
NIMHANS, Bangalore
Phone:(office) 91-080-26995278
Email:jreddy@nimhans.kar.nic.in

Dr. Sumant Khanna, MD, PhD, MAMS, MRC Psych

Consultant Psychiatrist, New Delhi
Former Additional Professor of Psychiatry, NIMHANS, Bangalore

Dr.Suresh Bada Math. MD, DNB, PGDMLE

Assistant Professor of Psychiatry
NIMHANS, Bangalore
Phone:(office) 91-080-26995276
Email:sbm@nimhans.kar.nic.in
Dr. Ravi Philiph Rajkumar. MD
Senior Resident,
NIMHANS, Bangalore

National Institute of Mental Health and Neuro Sciences,

(Deemed University),
Bangalore, 560 029 INDIA

OBSESSIVE-COMPULSIVE DISORDER
Patient information brochure

HINDI VERSION
Translated by

Dr. Prashant Tibrewal

YC Janardhan Reddy
Sumant Khanna
Suresh Bada Math
Ravi Philip Rajkumar

OCD Clinic,
Department of Psychiatry,
National Institute of Mental Health and Neuro Sciences,
(Deemed University), Bangalore, 560 029
INDIA
2008

Copyright NIMHANS, 2008. Bangalore, INDIA

vks-lh-Mh- D;k gS\

vks-lh-Mh- ,d vke ekufld chekjh gSA igys bls bruk vke ugha
le>k tkrk Fkk ijUrq fofHkUu v/;;uksa ls ;g fl) gks x;k gS fd foo
dh 2&3% tula[;k dHkh u dHkh bl chekjh ls xzflr jg pqdh gSA
gkykfd vks-lh-Mh- ,d vke chekjh gS] blls xzflr yksx bldk bykt
ugha djokrsA ifpeh nskksa esa 50% ls de vkSj Hkkjr esa blls Hkh de
yksxksa us bl chekjh ds fy, euksfpfdRld ls lEidZ fd;k gSA ;g
chekjh lHkh mez ds yksxkas dks gks ldrh gSA rdjhcu 65% yksxksa esa ;g
chekjh 25 lky dh mez ds igys gh gks tkrh gS ftuesa ls dqN esa rks
;g 5 lky dh mez ls gh 'kq# gks tkrh gSA 5 % ls de yksxksa esa ;g
chekjh 35 lky ds ckn gks ldrh gSA lkekU;r% ;g chekjh nksuksa fyaxksa
esa leku :i ls ik;h tkrh gS ij ;fn blds y{k.k cpiu vFkok
;qokoLFkk esa 'kq: gks tk, rc ;g yM+fd;ksa dh rqyuk esa yM+dksa esa T;knk
ik;h tkrh gSA bl chekjh ds eq[; y{k.k gSa %& vksCls'kUl vkSj
daiY'kUlA
tc dqN fopkj] bPNk] 'kadk ;k n`'; ckj&ckj bPNk ds fo#) vkrs
gSa] rc mUgsa vksCls'kUl dgk tkrk gSA
bl chekjh ls xzflr vf/kdrj yksx ;g tkurs gSa fd ;g fujk/kkj]
vko';drk ls vf/kd vkSj cseryc ds fopkj gSa ij og mu fopkjksa dks
jksd ugha ikrs gSaA vksCls'kUl yksxksa esa dkQh ruko vkSj ?kcjkgV iSnk djrs
gSa ftlls muds nSfud thou esa cgqr ck/kk iM+rh gSA
tc dksbZ O;fDr fdlh dk;Z dh fujZFkdrk dks tkurs gq, Hkh mls
ckj&ckj djus ij foo'k gksrk gS rc mUgs dEiY'kUl dgrs gSaA dEiY'kUl]
lkekU;r% vksCls'kUl ds frf;k Lo:i vFkok mUgsa jksdus ds fy, fd;s
tkrs gSaA tSls %& ftl O;fDr dks xUnxh dk vksCls'kUl gS] og ;g
lqfuf'pr djus ds fy, fd mlds gkFk lkQ gSa] mUgsa ckj&ckj /kksrk gSA
ejht ;g dksf'k'k djrs gSa fd og ckj&ckj gkFk u /kks,a] ij ,slk u
djus dh n'kk esa gksus okyh ?kcjkgV ds lkeus varr% og vius ?kqVus Vsd
nsrs gSaA
vks-lh-Mh- ds ejht fdlh lEHkkfor nq?kZVuk@[krjs dks Vkyus ds fy,
dqN dk;Z ckj&ckj nksgjkrs gSaA mnkgj.k ds rkSj ij %& Q'kZ dks ,d
fuf'pr ckj Nwuk rkfd ifjokj tuksa ds lkFk gksus okyh lEHkkfor nq?kZVuk
Vy tk,A vf/kdrj ejht ;g tkurs gSa fd muds f;k&dyki fujFkZd gSa
ij og bu ij fu;a=.k ugha dj ikrs D;ksafd blls mudh ?kcjkgV@cspSuh
de gksrh gS] Hkys gh FkksM+s le; ds fy,A
dqN dEiY'kUl dks ,d fo'ks"k i)fr ls fd;k tkrk gSA O;fDr fo'ks"k
fdlh dk;Z dks ,d foLr`r ec) rjhds ls djus ij foo'k gksrk gS vkSj
J`a[kyk VwVus dh n'kk esa iwjh f;k 'kq#vkr ls nksgjkuh iM+rh gS vU;Fkk
?kcjkgV cgqr c<+ tkrh gSA bl dkj.ko'k NksVs&NksVs dkeksa ds fy, cgqr
le; yx tkrk gSA
Copyright NIMHANS, 2008. Bangalore, INDIA

fdUgsa vksClskUl ugha dgk tkrk gS %&

lk/kkj.kr% ^^vksClskUl** kCn dk ;ksx ^^mls laxhr dk vksCls'kUl
gS** ,sls fd;k tkrk gS] ijUrq vks-lh-Mh- ds lUnHkZ esa ge bl
kCnkFkZ dk ;ksx ugha dj ldrs gSaA mijksDr mnkgj.k esa vkneh
viuh bPNk ls ml dke dks djrk gS vkSj ,slk djus esa mls [kqkh
feyrh gSA
tc fdlh dks ukSdjh ls fudkyk tkrk gS rc mldk bl ?kVuk dks
ysdj fpafrr gksuk LokHkkfod gSA ijUrq bu fopkjksa dks ge csotg
;k csdkj ugha dg ldrs gSaA blh rjg ls] ijh{kk ds igys ?kcjkgV
gksuk LokHkkfod gS] gkykfd buls ijskkuh gksrh gS ij bUgsa ge
fujk/kkj ugha dg ldrsA
lkQ gS fd mijksDr vuqHkoksa dks vksClskUl ugha dgk tk ldrk gSA
dqN vke vksClskUl
yksxksa ds Nwus ls ;k okrkoj.k ds phtksa ls xanxh yxus dk Mj
fu;e ds fo#) fopkj
nwljksa dks ;k [kqn dks gkfu igqpkus dk fopkj
kadk gksuk dh dke Bhd rjhds ls ugha fd;k x;k gSA
ySafxd fopkj ;k n`; ckj&ckj vkuk
xanh xkfy;k cksyus dk Mj
tku&ysok chekjh gksus dk Mj
gj pht dks] ,d gh ljhds ls j[kus dk fopkj
dqN vke daIykUl %
ckj&ckj gkFk /kksuk] ugkus ds fy, T;knk le; yxkuk ;k ?kj ds
phtksa dks ckj&ckj lkQ djuk
phtksa dks ,d ljhds ls j[kuk
rkyk] xSl vkSj ckh ds cVu vkSj bysfDVdy phtksa dks ckj&ckj
ij[kuk
[kqn ds diM+s dks ckj&ckj Mkyuk vkSj fudkyuk
ckj&ckj ,d vad rd fxurh djus jguk
dqN phtksa dks ,d gh jhfr esa Nwuk
dqN dke ckj&ckj djukA tSls & njokts ls ckgj tkdj ykSVuk
ckj&ckj nwljksa ls vkoklu ekxuk [kkldj cPpksa esa fn[kk nsrk
gS
xanxh dk Mj vkSj /kksus ;k lkQ djus ds daIykUl %
2

;g lcls vke vksClskUl gksrk gSA bl vksClskUl esa jkst ds dke djus
esa] xanxh yxus dk Mj yxk jgrk gSA tSls & njokts dh dqaMh Nwuk] uhps
fxjs gq, phtksa dks Nwuk] nwljksa ds Nq, gq, iSlksa ds uksV dks Nwuk ;k fdlh
dpjs ds fMCcs ds fudV ls tkukA bu lHkh dkeksa dks djus ls xanxh
yxus dk Mj yxk jgrk gSA ;g Mj cgqr T;knk vkSj jhfr;k cgqr yEcs
le; rd jgrs gSaA mnkgj.k % gkFk /kksus esa d ?kaVs yx ldrs gSa] ftlls
gkFk fNy ldrs gSaA yksx bl chekjh esa ?kj dks lkQ djus esa d ?kaVsa
yxk ldrs gSa ;k ugkus ds igys ckj&ckj ugkus dh txg dks lkQ djrs
jgrs gSaA
dqN yksxksa dks ;g Mj yxk jgrk gS fd muls ;k nwljksa ls QSyk x
xanxh vkSj xans dhVk.kq] mUgsa ;k nwljksa dks gkfu igqpk ldrs gSaA bl
dkj.k og [kqn ugkus rd ;k iwjs ?kj dks lkQ djus rd esgekuksa ds
tkus ds ckn nwljksa dks ugha Nwrs gSaA gkFk /kksus ds dk;Z esa dHkh&dHkh yach
jhfr;ksa dk bLrseky fd;k tkrk gSA tSls & gkFkksa dks ,d ljh[ks ls eyuk
;k ,d gh ljh[ks ls ugkukA tc bl jhfr dks ugha ekuk tkrk gS] rc
cspSuh vkSj ?kcjkgV T;knk c<+rh gS vkSj nksckjk ls ogh dke kq#vkr ls
djuk iM+rk gS tc rd larqf"V ugha feyrh ;k tc rd og Fkd ugha
tkrsA
kadk vkSj tkpus&ij[kus ds vksClskUl vkSj daIykUl
ftu yksxksa dks ;g vksClskUl gksrs gSa] muds eu esa ckj&ckj ;g kadk
iSnk gksrh gS fd muds Bhd ls u tkpus&ij[kus ls dqN cqjk gksus okyk gSA
lEHkkfor gknls dks Vkyus ds fy, ckj&ckj ejht tkprs&ij[krs gSa &
tcfd og tkurs gSa fd og lEHkor% lPpk esa ugha cny ldrk gSA
mnkgj.k & kadk gksuk dh] xSl can ugha fd;k x;k gS] ftlds otg ls
vkx yx ldrh gSA vke mnkgj.k gS & ckj&ckj njoktksa dh dqafM;ksa] xSl
ds cVu vkSj bysfDVd phtksa dks tkpukA vU; mnkgj.k & ckj&ckj :i;ksa
dks fxuuk] ,d gh dke dks ckj&ckj xyfr;ksa ds fy, ij[kuk [kkldj
cPpksa esa fn[kk nsrk gSA ijarq ckj&ckj tkpus ds ckn Hkh ;g yksx larq"V
ugha gksrs gSaA dHkh&dHkh ;g nwljksa ls vkoklu ekxrs gSa fd mUgksaus dks
[krjs okyh xyrh ugha dh gSA tu lk/kkj.k dks ;g yksx vkylh vkSj
dkepksj yxrs gSA ftu cPpksa dks ckj&ckj tkpus dk daIykUl gksrk gS]
og i<+k esa detksj ekus tkrs gSaA vxj bu yksxksa ls iwNk tk, fd
^^vki dc larq"V gksaxs fd njoktk can fd;k x;k gS\** dkQh yksx ;g
tokc nsaxas fd og dHkh Hkh bl ekeys esa larq"V ugha gks ldrs gSaA dqN
ejht tkpus&ij[kus ds le; dks de djus ds fy, dqN rjhds viukrs
gSaA lcls vke rjhdk tks viuk;k tkrk gS & fxurh djds tkpus&ij[kus
dh ckjh dks de djukA ;g ejht d ckj fxurh djus dh jhfr dh
vknr yxk ysrs gSa] tSls vPNs vkSj cqjs J`a[kyk ds vadksa dks ekuukA
phtksa dks ,d rjhds ls ;k ,d gh J`a[kyk esa j[kus dh vko;drk
ftu yksxksa esa ;g vksClskUl jgrk
j[kuk ilan djrs gSaA ijarq phtksa dks
ls T;knk /;ku yx tkrk gS] ftlds
dks kFkfedrk ugha ns ikrs gSaA gj

gS] og viuh phtksa dks lkQ&lqFkjk

lkQ&lqFkjk j[kus esa gh mudk vk/ks
otg ls og nwljs jkstejkZ ds dkeksa
pht dks ,d ljhds ls ;k ,d gh
3

J`a[kyk esa j[kuk mudh t:jr cu tkrh gSA vxj phtksa dks mYV&iqYV
fd;k tk,] rc mUgsa vlUurk gksrh gSA tc rd mudh phtksa dks
O;ofLFkr txgksa esa ugha j[kk tkrk rc rd mUgsa vthc lk ruko eglwl
gksrk gSA
;g yksx [kkus dh est dks rS;kj djus ds fy, ?kaVksa yxkrs gSa ;k rc rd
fcLrj yxkrs jgrs gSa tc rd og larq"V ugha gks tkrs gSa fd lkjh phtsa
Bhd txg esa j[kh x gSA
ySafxd vkSj vkksktfud fopkj ds vksClskUl %
ftu yksxksa dks ;g vksClskUl gksrk gS] mUgsa ckj&ckj ySafxd fopkj ;k
n`; fn[kk nsrk gSA mnkgj.k % ySafxd vksClskUl ifjokjokyksa ds fr ;k
Hkxoku ds fr ySafxd n`;ksa ds ek/;e ls vk ldrs gSaA vkksktfud
vksClskUl T;knkrj fdlh pkgusokys ifjokj ds yksx dks ekjus dh lksp
gksrk gSA tks yksx ySafxd vkSj vkksktfud fopkj ds vksClskUl ls ihfM+r
gSa] mUgsa ipkrki vkSj ?kcjkgV eglwl gksrk gSA mUgsa geskk ;g Mj yxk
jgrk gS fd og dgha vius ySafxd vkSj vkksktfud fopkj dks vly
ftanxh esa dj u cSBsA bl otg ls] og ckj&ckj nwljksa ls vkoklu
ekxrs jgrs gSa fd og vPNs bUlku gSa vkSj ,slh xanh gjdr ugha dj
ldrs gSaA
fxurh djus vkSj ,d pht dks ckj&ckj djus dh daIykUl %
ftu cPpksa esa vks-lh-Mh- dh chekjh gksrh gS vkSj og csotg phtksa dh
fxurh djus esa ?kaVksa yxkrs gSaA og lM+d esa pyrs gq, yksxksa dh] f[kM+dh
ds fxzy dh] QkZ ds VkbYl dh fxurh djrs jgrs gSaA dqN cPps dke kq:
djus ds igys ;k lekIr djus ds ,d vad rd fxurh djrs gSaA fdlh
Hkh txg dks ikj djus ds fy,] lhf<+;ksa dh fxurh djuk] og vko;d
le>rs gSaA ftu yksxksa dks ,d gh pht dks ckj&ckj djus ds daIykUl
gksrs gSa] og ,d gh dke dks ckj&ckj nksgjkrs gSaA tSls & dqlhZ ds
bnZ&fxnZ xksy&xksy ?kweuk ;k dqN vad rd pDdj dkVuk vkSj fQj dqlhZ
ij cSBukA
,d gh pht ds ckjs esa ckj&ckj lkspuk %
ftu yksxksa dks ;g vksClskUl gksrk gS] og csotg vkSj cseryc dh phtksa
esa viuh le; xokars gSaA og tkurs gSa fd ;g fopkj csotg gS ijarq og
mUgsa jksd ugha ikrs gSaA ;g lksp yacs le; rd pyrh gS vkSj ejht dks
vius gh uksa dk gy ugha fey ikrk gSA vke phtksa ij Hkh og kadk
djrs jgrs gSaA ;g lksp ;k kadk fnu esa fd;s x;s fdlh dk;Z ;k fdlh
ds lkFk dh x ckrphr ij gks ldrk gSA
phtksa dks tek djuk %
tc yksx iqjkus diM+s] crZu ;k dkxt vius Hkfo"; ds bLrseky ds fy,
j[krs gSa] rc mls [kkl ugha ekuk tkrk gSA ijarq ftu yksxksa dks vks-lh-Mhdh chekjh gksrh gS] og T;knk gn rd phtksa dks tek djrs gSaA ?kj okys
vkSj nksLr vDlj ;g fkdk;r djrs gSa fd ejht us vius dejs esa
csotg vkSj cseryc dh phtksa dks tek fd;k gSA bu ejhtksa dks viuh
phtksa dks ckj&ckj ij[kus vkSj tkpus dh vknr gksrh gS] ftlls og vius
4

vki dks vkoklu ns lds fd mudh lkjh phtsa lqjf{kr gSaA vxj dks
mUgsa bu phtksa dks Qsdus dh lykg ns] rc mUgsa cgqr T;knk ?kcjkgV
eglwl gksrh gSA
vks-lh-Mh- gksus ds dkj.k %
vks-lh-Mh- gksus dk lgh dkj.k vHkh rd Kkr ugha gSA ijarq oSKkfud
i<+k;ksa us vks-lh-Mh- ds lEHkkfor dkj.kksa dks nqfu;k ds lkeus isk fd;k
gSA bu dkj.kksa dks oSKkfud vkSj euksoSKkfud dkj.kksa esa ckVk tk ldrk gS
v

oSKkfud dkj.k

vkt dh fLFkfr esa ;g Li"V :i ls crk;k tk ldrk gS fd vks-lh-Mhgksus ds oSKkfud dkj.k gSa vkSj ;g gekjs efLr"d esa ik, x, dqN
dSfedy rRoksa esa cnyko vkus dh otg ls gks ldrk gSA ;g cnyko
gekjs efLr"d esa ik, x, U;wjksVkUlfeVlZ esa gksrk gS] ftudh enn ls
lwpuk gekjs fnekx ds jxksa rd igqprh gSA ftu yksxksa esa vks-lh-Mh- dh
chekjh ik tkrh gS] muesa fljksVksfuu uked ,d U;wjksVkUlfeVj dh deh
gksrh gSA bl ckr dk lcls cM+k lcwr gS oks nok;k tks ^fljksVksfuu* dks
Hkkfor djrh gSaA ;g nok;k gekjs fnekx esa ^fljksVksfuu* dh ek=k dks
c<+krs gSa & ftlls vks-lh-Mh- ds y{k.k de gksrs tkrs gSaA
vks-lh-Mh- dk jxksa dh vkSj chekfj;ksa ds lkFk gksuk mlds oSKkfud mn~Hko
dh iqf"V djrs gSaA ftu yksxksa dks ^,ulsQsySfVl*] ^fVd fMl~vkWMZj* vkSj
^dksfj;k* tSlh chekfj;k gksrh gSa] mUgsa vks-lh-Mh- gksus dh T;knk lEHkkouk
gSA efLr"d dh ,e-vkj-vk- vkSj ih--Vh- LdSu esas UVy yksCl]
flaaxqye vkSj csly xSaxfy;ksa esa vfu;ferrk,a ik;h x;h gSaA ,slk lkspk
tk jgk gS fd vks-lh-Mh- ds ejhtksa esa efLr"d ds bu rhu Hkkxksa dks
tksM+us okys lfdZV esa dqN [kjkch gks tkrh gSA
vktdy ;g ekuk tkrk gS fd vks-lh-Mh- ,d vkuqokafkd chekjh gks
ldrh gSA rdjhcu 3%&6% ejhtksa ds lxs&lEca/kh ekrk&firk] cgu&Hkk
vkSj cPps esa Hkh ;g chekjh ik;h tkrh gSA vks-lh-Mh- vkSj VwjsV fMlvkMZj
jxksa dh ,d chekjh dk Hkh vkil esa lEcU/k ik;k x;k gSA vks-lh-Mhds ejhtksa ds lxs&laca/kh dks vks-lh-Mh- vkSj VwjsV~ fMl~vkWMZj & nksuksa gksus
dh T;knk lEHkkouk gSA oSls gh VwjsV~ fMl~vkWMZj ds ejhtksa ds fjrsnkjksa dks]
vks-lh-Mh- gksus dh T;knk lEHkkouk gSA Kkr jgs fd vks-lh-Mh- ds
vkuqokafkd gksus ds ek.k dsoy dqN frkr ejhtksa esa gh ns[ks x, gSaA
T;knkrj ejhtksa ds fjrsnkjksa esa ;g ugha ik;h tkrh gSA
ruko dh Hkwfedk %
fdlh Hkh rjg dk ruko [kqn&c&[kqn vks-lh-Mh- dk dkj.k ugha ekuk tk
ldrk gSA ijarq jksx&o.k O;fDr;ksa esa ruko] vks-lh-Mh- pkyw gksus dk
eq[; dkj.k cu ldrk gSA ruko] chekjh ds y{k.k ;k gkykr dks T;knk
fcxkM+ ldrk gSA dqN vke rukoiw.kZ ?kVuk, tks bl chekjh dks kq: dj
ldrh gS & djhch yksxksa ls fcNqM+uk] ukSdjh xokuk] dke esa ijskkuh
eglwl djuk] xHkZorh gksuk vFkok xHkZikrA

Copyright NIMHANS, 2008. Bangalore, INDIA

O;fDro dh Hkwfedk %
dqN yksxksa dk O;fDro dh Hkwfedk ,slk gksrk gS fd og gj dke dks ,d
rjhds ls gh djrs gSaA T;knk le; mudk /;ku fu;e vkSj dke djus ds
lgh rjhdksa esa yxk jgrk gSA ;g ekuk tkrk gS fd ;g yksx
vksClsflo&daIyflo ilZukfyVh fMl~vkWMZj ds fkdkj gSa & u fd vks-lh-MhdsA ftu yksxksa dks ;g ilZukfyVh fMl~vkWMZj gksrk gS] mu yksxksa dks vkslh-Mh- gksus dh T;knk lEHkkouk gksrk gSA ijarq vks-lh- ilZukfyVh fMl~vkWMZj
gksus dk ;g eryc ugha gS fd bu yksxksa dks vks-lh-Mh- Hkh t:j gksxhA
T;knkrj ejht tks vks-lh-Mh- ds fkdkj gksrs gSa] mUgsa vks-lh- ilZukfyVh
fMl~vkWMZj ugha gksrk gSA ftu yksxksa esa vkRefookl de gksrk gS] tks
yksxksa dh vkykspuk ugha >sy ikrs vkSj ftu yksxksa dks ckgj tkus ;k
yksxksa ls feyus esa ?kcjkgV eglwl gksrh gS & bu yksxksa dks vks-lh-Mhgksus dh T;knk lEHkkouk gSA
c

euksoSKkfud dkj.k %

d lkyksa ls] euksoSKkfud ;g ekurs vk jgs gSa fd ftu yksxksa dks vkslh-Mh- gksrh gS muds ekrk&firk us mudh ijofjk vR;f/kd vuqkklu
vkSj dBksjrk ls dh gSA ijarq vc ;g ckr lkQ gS fd vks-lh-Mh- dk ,slk
dks dkj.k ugha gksrk gSA cpiu esa euksoSKkfud ruko ;k ijskkuh dh
otg ls vks-lhMh- ugha gksrh gSA
^yfuZax fFk;ksjh* ds eqrkfcd vksClskUl vkSj daIykUl nks pj.k esa iSnk
gksrs gSaA vksClskUl dSls iSnk gksrs gSa & blds iq[rk lcwr ugha gSa D;ksafd
ejht vksClskUl ds pkyw gksus ls igys dh ?kVukvksa dks ;kn ugha dj ikrs
gSaA ijarq ;g HkyhHkkafr fl) gks pqdk gS fd daIykUl vkSj Mj Hkkxus dh
o`fk] vksClskUl dks dk;e j[krh gSA
igys pj.k esa dks lk/kkj.k fopkj vFkok dYiuk fdlh ,slh nq?kZVuk ds
lkFk lEcfU/kr gks tkrh gS tks vius vki esa dkQh Mjkouh vkSj ?kcjkgV
iSnk djus okyh gksrh gSA QyLo:i og fopkj vkrs gh O;fDr ?kcjk tkrk
gSA
nwljs pj.k esa O;fDr bu ?kcjkgV iSnk djus okys fopkjksa@dYiukvksa ls nwj
Hkkxus yxrk gSA tSls & bl Mj ls pkdw dk bLrseky u djuk fd eSa
dgha fdlh dks ekj u cSBwA ,sls gj fopkj ?kcjkgV iSnk djrs gSa ftuls
Hkkxk ugha tk ldrkA ftlds QyLo:i daIykUl iSnk gksrs gSaA
mijksDr nksuksa rjhds nwj Hkkxuk@daIykUl {kf.kd gh lgh ijarq ?kcjkgV
de djrs gSaA QyLo:i ejht dks budh vknr iM+ tkrh gS vkSj mlds
fy, bl J`a[kyk dks rksM+ ikuk eqfdy gks tkrk gSA
vks-lh-Mh- vkSj vU; chekfj;k
vDlj vks-lh-Mh- nwljs ekufld chekfj;ksa ds lkFk ik;k tkrk gSA dqN
vke chekfj;k tks vks-lh-Mh- ds lkFk ik;h tkrh gSa & ^fMsku*] ^vU;
,aXtkbVh fMl~vkWMZj*] ^fVd fMl~vkWMZj*] ^Ldhtkssfu;k* vkSj uks dh chekjh
kjkc] flxjsV] xkatk bR;kfnA ,aXtkbVh fMl~vkWMZj tks vks-lh-Mh- ds lkFk
6

ik, tkrs gSa og gSa & iSfud fMl~vkWMZj] Qksfc;k vkSj tujykbTM ,aXtkbVh
fMl~vkWMZjA bu vU; chekfj;ksa dks igpkuuk vkSj mudk bykt djuk
vko;d gS] D;ksafd vxj budk bykt ugha fd;k x;k] rks kk;n vks-lhMh- dk Bhd rjg ls bykt ugha gks ik,xkA vks-lh-Mh- ds lkFk vU;
chekfj;ksa dk gksuk] ejht dh gkyr dks vkSj csdkj cuk ldrk gSA ftlls
og fcYdqy cscl gks ldrk gSA
vDlj ^fMsku* dh chekjh ejht dks vksClskUl vkSj daIykUl ls de
ijskkuh nsrk gSA ftu yksxksa dks vks-lh-Mh- ds lkFk fMsku dh chekjh
gksrh gS] mudk eu mnkl jgrk gS vkSj dke djus dh QqrhZ de gks tkrh
gSA og phtksa dk etk ugha ys ikrs gSa vkSj [ksy&dwn ds fr mudh #fp
de gks tkrh gSA og vius vki dks] lekt dks vkSj Hkfo"; dks grkk
utj ls ns[krs gSaA og vius gh dkfcfy;r vkSj {kerk dks utjvankt
djrs gSaA mUgsa yxrk gS fd thus dk dks eryc ugha gS vkSj dkQh yksx
vkRegR;k djus dh lksprs gSaA
ftu ejhtksa dks ^iSfud fMl~vkWMZj* gksrk gS] mUgsa ?kcjkgV ds nkSjs iM+rs gSaA
bu nkSjksa esa mUgsa ngkr eglwl gksrh gSA ejht vius gh /kM+duksa dh rst
xfr dks lqu ldrs gSa] mudh lkl Qwyus yxrh gS] T;knk ilhuk NwVrk
gS] gkFk dkirs gSa] isV esa mFky&iqFky eglwl gksrh gS vkSj ejus dk ;k
ikxy gksus dk Mj yxk jgrk gSA
ftu ejhtksa dks ^Qksfc;k* dh chekjh gksrh gS] mUgsa fdlh oLrq ;k ?kVuk
ds fr csotg Mj yxk jgrk gSA bldh otg ls og mu ?kVukeksa ls
lEcU/k ugha j[krs gSaA ftu ejhtksa dks ^vxksjkQksfc;k* dh chekjh gksrh gS]
mUgsa ,slh txgksa vkSj ?kVukvksa ls Mj yxk jgrk gS] tgk ls lEHkkfor nkSjs
ds le; vklkuh ls cp dj ugha fudy ldrs gSa] ;k vius cpko ds
fy, fdlh dks cqyk ugha ldrs gSaA mnkgj.k ds rkSj ij & ?kj ls vdsys
tkuk ;k ?kj rd vdsys lQj djuk] tgk HkhM+&HkkM+ T;knk gksrh gS] tSls
lCtheaMh] nqdku] Hkjh cl bR;kfnA
ftu ejhtksa dks ^lksky Qksfc;k* gksrk gS] og lkekftd txgksa ij ugha
tkrs gSa D;ksafd mUgsa Mj yxk jgrk gS fd lHkh yksxksa dk /;ku muij gSA
bu yksxksa dks ;g Mj Hkh yxrk gS fd og vutku yksxksas ds lkeus
keZukd crkZo dj jgs gSaA ftu ejhtksa dks ^tujykbTM ,aXtkbVh
fMlvkMZj* gksrk gS og gj oDr ?kcjkrs jgrs gSa vkSj rukoxzflr jgrs gSaA
bu yksxksa dks jkstejkZ dh ?kVukvksa vkSj ijskkfu;ksa ds ckjs esa yxkrkj
?kcjkgV eglwl gksrh gSA
ftu yksxksa dks ^fLtkssfu;k* dh chekjh gksrh gS] mUgs ^gSY;wfluskUl*
vkSj ^fMY;wtUl* gksrs gSaA mudks ,slh phtksa ij fookl gksrk gS] ftUgsa
muds nksLr ;k ifjokjokys ugha ekursA mudks dHkh&dHkkj ;g eglwl
gksrk gS fd muds lksp] dk;Z vkSj Hkkouk, fdlh vkSj ds dkcw esa gSaA dqN
yksx ;g fookl djrs gSa fd dks ckgjh ro rkdr ;k yksx muds eu
ds vanj fopkj Mky jgs gSa ;k muds ethZ ds f[kykQ muds fopkjksa dks
nwljksa dks nkkZ jgs gSaA og nwljksa ds dk;Z vkSj uh;r ij lansg djus yxrs
gSaA mUgsa vkoktasa lquk nsrh gSa ;k phtsa@yksx fn[kk nsrs gSa & tks nwljs
yksxksa dks fn[kk ;k lquk ugha nsrs gSaA tc vks-lh-Mh- fLtkssfu;k ds
7

lkFk ik tkrh gS] rc igys vks-lh-Mh- dks igpkuuk vkSj mldk bykt
djuk t:jh gks tkrk gS & ugha rks fLtkssfu;k ij dkcw ikuk eqfdy
gks ldrk gSA
rdjhcu 20%&30% vks-lh-Mh- ds ejht ?kcjkgV de djus ds fy, kjkc
dk lgkjk ysrs gSaA og fu;fer :i ls kjkc ihus yxrs gSa vkSj mUgsa
bldh yr iM+ tkrh gSA og kjkc ij fu;a=.k [kks cSBrs gSa vkSj bls
jksduk ;k de djuk muds ok esa ugha jgrkA jksdus dh nkk esa mUgsa
?kcjkgV] cspSuh] vfuk vkSj gkFkksa esa dEiu dh fkdk;r gksus yxrh gSA
vksClsflo & daIyflo Js.kh dh vU; chekfj;k
gkykafd vksClskUl vkSj daIykUl eq[;r% vks-lh-Mh- esa ns[ks tkrs gSa] mUgsa
vU; ekufld chekfj;ksa esa Hkh ik;k tk ldrk gSA bu chekfj;ksa vkSj
vks-lh-Mh- esa dqN lekurk, gksrh gSa tSls & y{k.k] dkj.k] bykt dk
vlj bR;kfn esa lekurk,A
vU; chekfj;ksa esa ckWMh fMlekWfQZd fMl~vkWMZj] VkbdksfVyksesfu;k] VwjsV~
fluMkse] [kkus dh chekfj;k] vR;f/kd tqvk [ksyus ;k phtksa dks [kjhnus
dh chekjh kkfey gSaA ;s chekfj;k vks-lh-Mh- ds lkFk vFkok LorU= :i
ls ik;h tk ldrh gSA
ckWMh fMlekWfQZd fMl~vkWMZj esa ejht dks ;g fpark yxh jgrh gS fd kk;n
mldh HkkSfrd :i js[kk] esa dqN deh gSA mnkgj.k % mldh ukd Vs<+h gS]
cky irys gSa ;k mldk peM+k [kjkc gSA tjk lh Hkh deh dks og t:jr
ls T;knk ego nsrs gSaA ;g yksx vkus ds lkeus viuh dfe;ksa dks
tkpus ds fy, T;knk le; yxkrs gSaA og psgjs ij esdvi yxkrs gSa
rkfd mudh dfe;k fNi ldsaA viuh dfe;ksa dks Nqikus ds fy, ;s yksx
MkDVjksa ds] [kkldj IykfLVd ltZuksa ds] ckj&ckj pDdj yxkrs gSaA
VkbdksfVyksesfu;k ;k tkucw>dj [kqn ds
ejht tkucw>dj ckj&ckj [kqn ds ckyksa
igys bu yksxksa dks ruko eglwl gksrk gS
jkgr eglwl gksrk gSA kjhj ds fdlh Hkh
gSA T;knkrj ;g ejht vius lj ds ckyksa

cky fudkyus dh chekjh esa

dks [khaprs gSaA cky [khapus ds
vkSj [khap ysus ds ckn [kqkh ;k
fgLls ls cky [khapk tk ldrk
dks [khaprs gSaA

ftu ejhtksa dks VwjsV~V fluMkse gksrk gS] muds kjhj ds vax] fcuk mudh
bPNk ds fgyrs gSaA tSls lj vkSj dU/ks dk vpkud >Vdk ysuk] vk[kksa dk
QM+duk bR;kfnA blds vykok] muds bPNk ds fo#) vkoktsa fudyrh gSa(
mnkgj.k % xyk lkQ djuk] fpYykuk] fgPpdh vkuk vkSj og xanh ckrsa
cksy cSBrs gSaA
[kkuk] [kjhnnkjh djuk vkSj dHkh tqvk [ksyuk vke vkSj jkstejkZ dh
ftanxh dk ,d fgLlk ekuk tkrk gSA ijarq tc ;gh dk;Z T;knk ek;us esa
gksrk gS] yksxksa esa ?kcjkgV iSnk djrk gS vkSj muij dkcw ikuk eqfdy gks
tkrk gS] rc mUgsa ^fVax fMl~vkWMZj*] dEiyflo ckax] iSFkksykWftdy
xSEcfyax dgk tkrk gSA
vks-lh-Mh- ds fy, nok;k %
1980 rd vks-lh-Mh- ds bykt ds fy, dks Hkh vljnkj nok miyC/k
ugha FkhA ijarq mlh le; ls nok;ksa ds ,d oxZ dks bl chekjh esa
8

vljnkj ik;k x;k gS vkSj u nok;k tks bl oxZ esa kkfey gSa] og Hkh
vljnkj lkfcr gq gSaA bl nok;ksa ds oxZ dks ^fljksVksfuau jh&viVsd
bfUgfcVlZ* dgk tkrk gSA gekjs efLr"d esa U;wjksVkafLeVj uked jlk;u
ik;s tkrs gSaA fljksVksfuu ,d rjg dk U;wjksVkafLeVj gksrk gSA ;g nok;k
gekjs efLr"d esa fljksVksfuu dh ek=k dks c<+kus dk dke djrh gSA tks
nok;k nwljs U;wjksVkafLeVj ds Hkkxksa ij dke djrh gSa] tSls Mksikehu
,UVh lkbdksfVd nok,sa] uksj,Mhusyhu vU; ,UVh&MhslsUV nok ;k xk
ck jhlsIVj dkEIysDl flMsfVo fgiuksfVd nok] og vks-lh-Mh- ds bykt
esa vljnkj ugha gksrh gSA vks-lh-Mh- esa ftu nok;ksa dk oxZ bLrseky
fd;k tkrk gS & muesa Dyksehehu uked ,d nok lcls iqjkuh nok
gSA u nok;k tks bl oxZ esa kfey dh x gSa] og gSa &
ywvksdlksVhu] ywoksDlksehu] ljVsfyu] ikWjksDlVhu] bfLlVykske vkSj
flVykskeA igys ;g lkjh nok Hkkjr esa miyC/k ugha FkhaA bu esa ls
dks Hkh ,d nok vU; nok;ksa ls vks-lh-Mh- chekjh ds fy, Js"B ugha
ekuh tkrh gSA
bu lHkh nok;ksa dks] ,UVh MhslsUV uked nok;ksa ds ,d cM++s oxZ esa
kkfey fd;k x;k gSA cgqr le; ls ;g fookn py jgk Fkk fd D;k bu
nok;ksa ls fMsku ;k vks-lh-Mh- dk bykt gksrk gS\ T;knkrj oSKkfud
bl ckr ij lger gS fd gkykafd ;g nok;k Mhsku esa T;knk vlj
fn[kkrh gSa] ;g dkQh gn rd vks-lh-Mh- dk bykt djus esa Hkh lQy
jgh gSaA blds ;g ek;us gq, fd vkidks Mhsku gks ;k u gks] ;g
nok;k vki dh vks-lh-Mh- ij dke djsaxhA
nok dk pquko mlds lkbM bQSDV~l vkSj ml nok ij MkDVj ds fookl
ij fuHkZj djrk gSA tks nok;k T;knkrj vks-lh-Mh- chekjh ds bykt ds
fy, nh tkrh gSa] og gSa & Dyksfeehu] ljVsfyu vkSj ywvkDlVhuA ge
bu nok;ksa ij foLrkj ls ppkZ djsaxsA
Dyksfeehu ,d VklkbfDyd ,UVh fMslsaV ekuk tkrk gSA fljksVksfuu {ks=
ij mldk vlj Hkkokkyh gksrk gS] gkykafd og vU; U;wjksVkafLeVlZ ij
Hkh viuk dke djrk gSA ;g nok 150&250 ,e-th- dh ek=k esa]
frfnu ckVdj fn;k tkrk gSA dqN foks"k ifjfLFkfr esa bl nok dks
T;knk ek=k esa fn;k tk ldrk gS 300 ,e-th- rdA nok dh ek=k
/khjs&/khjs c<+k tkrh gS] D;ksafd bl nok ds lkbM&bQSDV~l T;knkrj
150 ,e-th- dh ek=k ds ckn fn[kk nsrs gSaA bl nok ds eq[;
lkbM&bQSDV~l & eqg dk lw[kuk] gkFk&iSj dkiuk vkSj dCt gksuk] gksrk
gSA dHkh&dHkkj vk[kksa dk /kq/kykuk vkSj fexhZ vkus dh nok dh T;knk
ek=k esa lEHkkouk gksrh gSA T;knkrj ;g lkbM&bQSDV~l dkQh rdyhQ
nsrh gSA vxj ;g rdyhQ t:jr ls T;knk gks rks mlds fy, vki vius
MkWDVj ls lEidZ dj ldrs gSa rkfd og vkids nok dh ek=k dks ;k rks
?kVk ldrs gSa] /khjs&/khjs c<+k ldrs gSa ;k nok cny ldrs gSaA
ywvkDLVhu nok fljksVksfuu jh&viVsd {ks= dk ,d [kkl bufgfcVj gSA
fMsku ds fy, ;g nok 20 ,e-th- dh ek=k esa nh tkrh gSA ijarq vkslh-Mh- esa 60 ls 80 ,e-th- dh ek=k esa bl nok dks nsus ls ;g
vljnk;d lkfcr gksrh gSA ywvkDLVhu T;knkrj ,d vdsyh xksyh lqcg
esa ;k ,d&,d xksyh lqcg vkSj nksigj dks nh tkrh gSA bl nok ds
Copyright NIMHANS, 2008. Bangalore, INDIA

eq[; lkM&bQSDV~l gS de uhan vkuk vkSj cspSuh eglwl djukA uhan u

vkus dh lkM&bQSDV~l dh otg ls ywvkDLVhu nok lqcg esa nh tkrh
gSA kq#vkr esa tc ;g nok T;knk ek=k esa yh tkrh gS rc dHkh&dHkkj
lkM&bQSDV~l utj vkrs gSaA
fdrus le; rd nok;k pkyw j[kuh gS & ;g Bhd ls crk;k ugha tk
ldrk gSA oSKkfud v/;;uksa us ;g fn[kk;k gS fd nok;k 1 & 2 lky
ds fy, vljnk;d gksrh gSA ijarq bykt dc can djuk pkfg,] ;g lkQ
crk;k ugha x;k gSA dqN v/;;uksa us ;g crk;k gS fd nok can djus ls
60% ls 80% lEHkkouk gS fd chekjh nksckjk gks ldrh gSA dks Hkh
v/;;u] nok;k vkSj fcgsfo;j Fksjsih vkSj nok jksdus ds vlj ij
lwpuk ugha nsrh gSA vxj nok;ksa ds lkFk ejht fu;a=.k esa gS] rc
MkWDVj /khjs&/khjs nok;ksa dks de djds] jksd ldrk gSA nok jksdus ds
ckn ;g ns[kuk t:jh gS fd D;k chekjh ds y{k.k nksckjk dV gksrs gSa
fd ughaA vxj chekjh ds y{k.k nksckjk dV ugha gksrs gSaA rc nok;k
ysus dh t:jr ugha iM+rh gSA ijarq vxj chekjh ds y{k.k nksckjk dV
gksrs gSa] rc nok;k kq: djuh iM+rh gSaA ;g nqHkkZX;iw.kZ ckr gS fd vkslh-Mh- ,d yacs vjls dh chekjh gS vkSj bldk bykt yacs le; rd
fd;k tkrk gSA bl lUnHkZ esa mldh rqyuk e/kqesg ;k mPp jDrpki ls
dh tk ldrh gSA ijUrq chekjh ds fu;a=.k esa vkus ds ckn] nok dh
ek=k de dh tk ldrh gSA
nok /khjs&/khjs 1&3 eghus ds le; esa de dh tkrh gSA bykt ds 6
eghus ls 1 lky ds ckn] vxj chekjh fu;a=.k esa gS] rc nok dh ek=k
60% rd de dh tkrh gSA
nqHkkZX;iw.kZ ckr ;g gS fd dkQh Qhlnh ejht rdjhcu 40% ,d gh
nok ds ysus ls Bhd ugha gks ikrs gSaA vxj nok ds lkFk fcgsfo;j Fksjsih
Hkh bLrseky fd;k tkrk gS] rc flQZ 20%30% ejhtksa dks ,d ls T;knk
nok;ksa dh t:jr iM+rh gSA bu ejhtksa ds fy, nwljh nok;k nsus dk
mik; fd;k tkrk gS & tSls Dyksukftike] yhFkh;e] bR;kfnA vki ds
MkWDVj vkidks bu nok;ksa ds ckjs esa T;knk tkudkjh ns ldrs gSa] vxj
bl rjg dk bykt t:jh yxsA
gekjs yk[k dksfkkksa ds ckotwn FkksM+s&cgqr ejht bykt ls Bhd ugha gks
ikrs gSaA bu ejhtksa ds fy, lkbdksltZjh ,d vkf[kjh fodYi ekuk tkrk
gSA bl rjg ds bykt ds dsU vkt Hkkjr esa miyC/k ugha gSaA ijarq tc
budh vko;drk iM+sxh] rc kk;n bu dsUksa dks LFkkfir fd;k tk,xkA
vks-lh-Mh- chekjh ds fy, fcgsfo;j Fksjsih %
fcgsfo;j Fksjsih D;k gksrk gS\
fcgsfo;j Fksjsih ,d bykt lewg gksrk gS ftlls cqjs vkpj.k vPNs vkpj.k
esa cnys tk ldrs gSaA vks-lh-Mh- ds y{k.k & vkClskUl vkSj daIykUl dks
cqjs vkpj.k ds vUrxZr ekuk tkrk gS D;ksafd og vkneh ds jkstejkZ ds
dkedkt esa ck/kk Mkyrs gSa vkSj muls dkQh rdyhQ eglwl gksrh gSA
fcgsfo;j Fksjsih bu vkClskUl vkSj daIykUl ls NqVdkjk fnykus esa enn
djrk gS & ftlls ejhtksa dks de rdyhQ eglwl gksrh gSA
10

vks-lh-Mh- ds bykt esa fcgsfo;j Fksjsih dh d rduhdsa bLrseky dh tkrh

gSaA bu esa ls ^,Dlikstj vkSj fjLikWUl fosUku* ?kcjkgV iSnk djus okyh
fLFkfr@pht ls ifjfpr djuk vkSj ejht ds ml fLFkfr esa dh x;h
frf;k dks jksduk dkQh ;ksx dh tkrh gSs vkSj vljnk;d Hkh ekuh
tkrh gSA ;g 60% & 80% vks-lh-Mh- ds ejhtksa esa vljnk;d gksrh gSA

fcgsfo;j Fksjsih D;ksa bLrseky dh tkrh gS\

ge tkurs gSa fd T;knkrj ejht nksuksa vkClskUl vkSj daIykUl ls ihfM+r
gksrs gSaA daIykUl ?kcjkgV ;k rdyhQ de djus ds fy, fd, tkrs gSa
vkSj bl rjg vksClskUl ds lkFk laidZ j[krs gSaA FkksM+s nsj ds fy, gh
lgh] ijarq daIykUl ?kcjkgV de djus esa enn djrh gSA blfy, og
vknr cu tkrh gS vkSj vksClskUl ds tokc esa og vDlj bLrseky dh
tkrh gSA le; ds lkFk] tks daIykUl ?kcjkgV de djus ds fy, dh
tkrh Fkh] ogh daIykUl ?kcjkgV dh tM+ cu tkrh gSA lgt kCnksa esa &
vksClskUl daIykUl dks iSnk djrh gS vkSj D;ksafd daIykUl vksClskUl ls
iSnk gq ?kcjkgV dks de djrh gS] og dk;e jgrh gS vkSj ,d etcwr
J`a[kyk cukrh gS] ftls rksM+uk eqfdy gks tkrk gSA
^^,Dlikstj vkSj fjLikWUl fosUku** dh rduhd] tks Hkkoukvksa ds
^gkWfcpq, ku* uked fl)kar ij dk;e gS og bl J`a[kyk dks rksM+ ldrk
gSA ^gkWfcpq, ku* dk eryc D;k gS\ ;g ,d vke fl)kar ij vk/kkfjr
gSA blesa ;g ekuk tkrk gS fd csotg Mj vkSj vkpj.k] Mj ;k ?kcjkgV
iSnk djusokyh pht dks ckj&ckj fn[kkus ls xk;c gks tkrh gSA ckj&ckj
vkSj yacs le; rd Mj iSnk djusokyh pht dks fn[kkus ls balku dks
mldh vknr gks tkrh gS ;k ?kcjkgV vkSj cspSuh dh vknr ml gn rd
gks tkrh gS] tc rd ogh nnZukd pht Mj iSnk djus dh {kerk [kks nsrk
gSA ijarq ftu ejhtksa dks vks-lh-Mh- gksrk gS] og vius Mj vkSj ?kcjkgV
dks de djus ds fy, daIykUl dk lg;ksx ysrs gSa ;k mu lkjh phtksa ls
nwj jgrs gSa tks lEHkor% vksClskUl dks iSnk dj ldrh gSaA blds fo#)
fcgsfo;j Fksjsih esa ejht dks ;g ksRlkgu fn;k tkrk gS fd og /khjs&/khjs
Mj iSnk djusokyh ?kVukvksa dk lkeuk djs vkSj viuh cspSuh ls tw>sA
ejht ls ;g Hkh dgk tkrk gS fd og Mj iSnk djusokyh ?kVukvksa ls nwj
ugha jgs vkSj daIykUl dh lgk;rk u ysA daIykUl dh lgk;rk u ysus
ls vksClskUl ls tqM+h gq ?kcjkgV /khjs&/khjs de gks tkrh gSA tc ejht
dks ?kcjkgV dh vknr iM+ tkrh gS rc vksClskUl vkSj daIykUl /khjs&/khjs
de gks tkrs gSaA
mnkgj.k % dqN ejht xanxh ds Mj ls ckj&ckj gkFk /kksrs gSa] [kkldj tc
Hkh njoktksa dh dqafM;ksa dks Nwrs gSa & fcgsfo;j Fksjsih esa bu ejhtksa dks
ckj&ckj njoktkas dh dqafM;ksa dks Nwus dk ksRlkgu fn;k tkrk gS ijarq fcuk
gkFk /kks,A bl rjg djus ls] ejht dh ?kcjkgV T;knk c<+rh gSA ijarq
/khjs&/khjs le; ds lkFk] [kqn&c&[kqn ;g ?kcjkgV de gks tkrh gS vkSj
ejht dks mldh vknr iM+ tkrh gSA vxj ejht gkFk /kksrk gS] rc
?kcjkgV rqjar de gks tkrh gS] ijarq mls ?kcjkgV dh vknr ugha iM+rh gSA
11

bl otg ls] xanxh dk Mj dk;e jgrk gS vkSj ejht dks

ls fuiVus ds fy, yacs vkSj ekufld ncko iSnk djus okys
lgk;rk ysuh iM+rh gSA bl etcwr J`a[kyk dks rksM+us ds
rjhdk gS & ,Dlikstj [kqn ml fLFkfr dk lkeuk djuk]
/kksukA ckj&ckj ^,Dlikstj* ls xanxh dk Mj /khjs&/khjs NwV
bl otg ls gkFk&/kksus dk daIykUl Hkh NwV tkrk gSA

xanxh ds Mj
daIykUl dh
fy, ,d gh
ijarq gkFk u
tkrk gS vkSj

chekjh ds y{k.k dh tkp vkSj bykt %

1
igys] lHkh vksClskUl vkSj daIykUl dks /;ku ls vkSj foLrkj ls
fy[kuk pkfg,A
2
blds ckn] og lkjh pht vkSj fLFkfr tks vksClskUl vkSj daIykUl
iSnk djrh gSa] mUgsa igpkudj ,d ?kVrs gq, e esa ij ls uhps fy[kuk
pkfg,A lcls uhps] lcls de ?kcjkgV iSnk djusokyh fLFkfr vkSj lcls
ij lcls T;knk ?kcjkgV iSnk djusokyh fLFkfrA
3
ec) rjhds ls fd, tkus okys daIykUl dks jksdus ds fy,] mu
lkjh fLFkfr;ksa vkSj phtksa ds ckjs esa tkudkjh gkfly dh tkrh gS] ftlls
ejht nwj jgrk gSA mnkgj.k %& ejht lkekftd kkSpky; bLrseky djus
esa drjkrk gS D;ksafd og vius gkFk vkSj diM+s dks T;knk ugha /kksuk
pkgrk gSA phtsa vkSj fLFkfr dh rjg] dqN fopkj vkSj n`;] ?kcjkgV ;k
cspSuh iSnk dj ldrh gSa vkSj ejht bu ifjfLFkfr;ksa esa iM+us ls Mjrk gSA
mnkgj.k %& Hkxoku dh rLohj ns[kdj ;k eafnj tkus ls] Hkxoku ds fr
eu esa xans fopkj iSnk gksukA bu fopkjksa ls NqVdkjk ikus ds fy,] ejht
cgqr ckj eafnj tkuk ;k kFkZuk djuk jksd nsrk gSA
4
dqN ejhtksa dks] vksClskUl vkSj daIykUl flQZ ?kj esa jgrs le;
eglwl gksrk gSA bl tkudkjh dks gkfly djuk t:jh gks tkrk gS D;ksafd
bl fLFkfr esa bykt iwjh rjg ?kj esa gh gksrk gS vkSj ?kjokyksa dk lg;ksx
cgqr egoiw.kZ gks tkrk gSA
5
varr% dqN ejhtksa ds daIykUl ?kjokyksa ds vkpj.k ls T;knk dk;e
jgrs gSaA bl fLFkfr eas] bykt djrs le; ?kjokyksa dk lg;ksx fy;k
tkrk gSA
igys ls gh ;g tku ysuk t:jh gS fd bykt rdyhQ iSnk djrk gSA
vxj ejht var esa lqdwu gkfly djuk pkgrk gS] rc ejht dks rdyhQ
>syus ds fy, rS;kj gksuk pkfg,A fdl xfr ls ejht vius gh
HkkoukRed frf;kvksa ls ifjfpr gksrk gS] ;g gj ejht esa leku ugha
gksrk gSA dqN vkpj.k ^,Dlikstj* ds dqN le; 30 feuV esa gh urhtk
fn[kkrs gSa] ijarq dqN vU; vkpj.k dks yacs ^,Dlikstj* dh t:jr gksrh gS
2&3 ?kaVs] ftlls ?kcjkgV de gksrh gSA T;knkrj ifjfLFkfr;ksa esa
daIykUl igys de gksrs gSa] ijarq vksClskUl de gksus esa T;knk le;
yxkrs gSaA dkQh vksClskUl ^,Dlikstj vkSj jsLikWUl fosUku* ds 10 ls
12 ?kaVs ds ckn urhtk fn[kkrs gSaA vPNs ifj.kke ds fy, Bhd gksus dk
n`<+ ladYi vkSj kq:vkrh nkSj esa gksus okyh ijskkuh ls tw>us dh {kerk
gksuk vko;d gSA
vks-lh-Mh- ds bykt esa ifjokj dh Hkwfedk
12

gekjk vuqHko ;g dgrk gS fd ifjokj dk lg;ksx vks-lh-Mh- ds bykt esa

dkQh egoiw.kZ Hkwfedk fuHkkrk gSA T;knkrj vks-lh-Mh- iwjs ifjokj dks
Hkkfor djrk gSA vks-lh-Mh- ds otg ls ifjokj esa T;knk ruko iSnk gks
ldrk gS] ftlls ifr&iRuh ds chp esa vucu ;k fMokslZ gks ldrk gSA
dqN ifjokj] vius cPpksa ;k thou&lkFkh ds chekjh ds fy, [kqn dks
ftEesnkj ekurs gSaA tc dHkh nksLr vkSj fjrsnkj ijkekZ nsrs gSa fd ejht
chekj ugha gS & flQZ cqjs oDr ls xqtj jgk gS vkSj T;knk fu;a=.k vkSj
/;ku j[kus ls ejht dh ijskkuh nwj gks ldrh gS( rc ifjokj dks T;knk
nq[k vkSj keZ eglwl gks ldrk gSA ifjokj esa geskk ;g kadk jgrh gS
fd D;k ejht ds daIykUl muds chekjh dk gh ,d Hkkx gS ;k og
mudk /;ku vkdf"kZr djus ds fy, tkucw>dj dj jgs gSaA gj ifjokj
eq[;r% rhu rjg ls vks-lh-Mh- ls tw>rk gS % lg;ksx ls] vkksk ls vkSj
dqN lg;ksx ;k vkksk ls bu ifjokjksa dks ^fLIyV Qsfeyh* dgk tkrk
gSA
lg;ksxh ifjokj T;knkrj ejht ds fr t:jr ls T;knk mRlkg] NwV ;k
n[kyvankth fn[kkrs gSaA ifjokj ds lnL; feydj ejht dks daIykUl
djus esa enn djrs gSa] rkfd ?kj esa Nk;k ruko ?kV tk,A ;g ejht ds
bykt esa gkfu igqpkrk gS vkSj ?kj esa ruko iSnk djrk gSA blds foijhr
vkksktud ifjokj] ejht ds ijskkfu;ksa esa kkfey ugha gksrs gSaA og
dBksj] vyx&vyx] frdwy] vkykspd vkSj ltk esa ;dhu djus okys
gksrs gSaA ifjokj ds lnL;ksa ds chp esa xqLlk vkSj yM+k vkSj dHkh&dHkkj
fgalk vke ckr gksrh gSA fLIyV Qsfeyh esa] dqN yksx t:jr ls mRlkg
trkrs gSa vkSj ckdh ds yksx vkykspd] frdwy vkSj dBksj gksrs gSaA ij
fn, x, rhu rjg ds ifjokj ds vkpj.k vks-lh-Mh- ds bykt ds fy,
ljkguh; ugha ekus tkrs gSaA blfy, vks-lh-Mh- ds bykt esa ifjokj okyksa
dk kkfey gksuk t:jh ekuk tkrk gS] [kkldj fcgsfo;j Fksjsih djus esa
vkSj nok nsrs le;] fuxjkuh j[kus esaA
lPph ?kVuk, % dqN mnkgj.k
,d 25 lky dh x`g.kh dks mlds ifr vkSj lkl&llqj vLirky ys
vk,] bl ijskkuh ds lkFk fd og vius gkFk /kksus ds fy, ?kaVksa
yxkrh FkhA tkp&iM+rky djus ij ejht us ;g crk;k fd og Mjrh
Fkh fd mlds gkFk lkQ&lqFkjs ugha gSa vkSj bl otg ls og ckj&ckj
viuk gkFk /kksrh Fkh] rkfd mlds gkFk lkQ gksaA og nwljksa ds Nq,
x, njoktksa dh dqafM;k] f[kM+fd;k] ckYVh vkSj ex ugha Nwrh FkhA
og nwljksa ds bLrseky dh x;h kkSpky; esa Hkh ugha tkrh FkhA nkrksa
dks ektus ds fy, 30 feuV yxkrh D;ksafd og Mjrh Fkh fd mlds
nkr lkQ ugha gSaA bl LoPNrk ds tquwu dh otg ls] og gj ml
pht dks] tks mlds fglkc ls xank Fkk] mldks Nwus ds ckn viuk
gkFk /kksus ds fy, 20&30 feuV yxkrh FkhA mnkgj.k % njoktksa dh
dqafM;k] [kkus dh est] da?kh] lkcqu dk fMCckA og gj ckj ugkus
ds igys ckFk:e] ckYVh] ex o uy ,oa lkcqu dks rdjhcu ,d
ls nks ?kaVs rd /kksrh FkhA mlds ckn og ugkus ds fy, vkSj nks ?kaVs
yxkrh FkhA mldk Mj fd og iwjh rjg LoPN ugha gS] mls ckj&ckj
lkcqu yxkus ds fy, etcwj djrk Fkk vkSj bl otg ls og
Copyright NIMHANS, 2008. Bangalore, INDIA

13

ugkdj ckgj vkus rd iwjh rjg Fkd tkrh FkhA mldh iwjh ftanxh
vkSj jkst ds dke iwjh rjg LoPNrk ds fopkjksa esa chrrs Fks vkSj mls
nwljs dke djus dk cgqr de le; feyrk FkkA vktdy] mldk
lkQ jgus dk vksClskUl bl gn rd igqp x;k gS fd og vius
ifr dks dks Hkh dke djus ls igys gkFk /kksus ds fy, etcwj
djrh gSA mls ;g ,glkl gS fd mlds lQk ds fopkj csdkj vkSj
vko;drk ls vf/kd gSaA ijarq og T;knk ?kcjkgV dh otg ls bu
fopkjksa ij dkcw ugha ik ldrh FkhA
30 lky dh mez ds ,d vkneh cSad esa dSfk;j dk dke djrs FksA
mUgs ;g kadk Fkh fd xzkgd dks iSls nsus ds igys] mUgksauas iSlksa dks
Bhd rjg ls fxuk ugha gSA mudh kadk ;g Fkh fd kk;n mUgksaus
xzkgd dks de ;k T;knk iSls ns fn, gSaA vxj T;knk iSls ns fn,
x, rc mUgsa ftEesnkj Bgjk;k tkrk vkSj vxj de iSls fn, x,
rc xzkgd muij fpYykrsA ;g kd muds dke djus esa ck/kk
Mkyrh FkhA gj eghus ds igys grs esa T;knk ijskkuh gksrh Fkh] tc
cgqr lkjs xzkgd ml ij fpYykrs FksA muds cSad eSustj us Hkh muds
dke djus ds rjhds ij psrkouh nh vkSj bl otg ls og vkfQl
esa glh ds ik= cu x,A blls mUgsa kfeZUnxh vkSj nq[k eglwl
gksrk FkkA tkp iM+rky djus ds ckn] mUgksaus ;g cryk;k fd jkr
dks lksus ds igys] og vius ?kj ds njoktksa dh dqafM;k Hkh ckj&ckj
tkprs Fks] rdjhcu 10&15 ckjA og bysfDVd dh phtksa dks Hkh
ckj&ckj tkprs Fks] ;g tkuus ds fy, fd og Bhd rjg ls can
fd;k x;k gS fd ughaA ;g tkpus vkSj fxurh djus ds fu;e
cspSuh vkSj ?kcjkgV iSnk djrh Fkh D;ksafd mUgsa irk Fkk fd og
t:jr ls T;knk csdkj dh kadk FkhA
MkWDVj us 16 lky ds Nk= dks ;g dgdj bykt ds fy, Hkstk fd
og dHkh Hkh Ldwy oDr ij ugha igqprk Fkk] D;ksafd T;knk oDr
Ldwy tkus dh rS;kjh esa yxkrk FkkA mlds ekrk&firk ;g dgrs Fks
fd og vius est ij ;k cSx esa j[kh x;h fdrkcksa ds j[kus ds
rjhds ls dHkh Hkh larq"V ugha FkkA og gj lqcg Ldwy ls lEcfU/kr
lHkh phtksa dks ckj&ckj j[kus ds fy, 3 ?kaVs yxkrk Fkk] ftlds
dkj.k mls geskk nsj gks tkrh FkhA mlds ?kjokys mls tYnh djus ds
fy, tcjnLrh djrs FksA vxj dks mldh phtksa dks Nwrk] rc og
cgqr T;knk nq[kh gks tkrk FkkA ?kjokyksa us ;g Hkh crk;k gS fd og
jkr dks lksus ls igys] fcLrj cukus ds fy, rdjhcu ,d ?kaVk
yxkrk FkkA phtksa dks lgh rjhds ls j[kus dk tquwu mls i<+k]
gkse&odZ vkSj Ldwy ds ckdh dke ds fy, cgqr de le; nsrk
FkkA bldh otg ls og i<+k esa detksj gksrk x;k vkSj mlds
fk{kd mlds i<+k esa detksj gksus ij MkVrs FksA
23 lky ds ,d d`f"k oSKkfud dks vkSjrksa dks ns[kus ij ckj&ckj
muds uaxs gksus dk n`; vkrk FkkA viuh ek] cgu vkSj NksVh
yM+fd;ksa dks ns[kus ij Hkh mUgsa ;g n`; vkrk FkkA ;g csotg vkSj
okg~;kr fopkj muds eu esa cgqr ?kcjkgV vkSj ipkrki iSnk djrs
FksA blds otg ls mUgsa fMsku vkSj vkRegR;k ds [;ky vkus yxsA
14

og vkSjrksa ls utj fNikrs Fks viuh gh ek vkSj cgu ls Hkh vkSj

T;knk vdsys jgus yxsA tgk vkSjrksa ls feyus dh laHkkouk gksrh
Fkh] mu lkekftd dk;Zeksa esa mUgksaus tkuk can dj fn;kA mUgksaus
bu n`;ksa ls NqVdkjk ikus ds fy,] eu gh eu esa kFkZuk kq: dj
fn;k] ijarq og uaxs n`;ksa ij dkcw ugha ik ldsA muds ?kjokys mUgsa
fMsku vkSj vkRegR;k djus dh dksfkk ij vLirky ys vk,A
,d 26 lky dh MkWDVj dks] nwljksa dks ekjus dk fopkj vkrk FkkA
;g lksp muesa T;knk ?kcjkgV vkSj iNrkok iSnk djrk Fkk D;ksafd
;g lksp muds [kqk fetkt O;fDro ls fcYdqy foijhr FkkA ;g
lksp muesa rc T;knk gksrk Fkk] tc og viuh 3 lky dh csVh ds
lkFk gksrh FkhA mUgsa ;g Mj yxk jgrk Fkk fd og vius gh csVh dks
pkdw ls ekj MkysaxhA bl otg ls mUgsa tku&cw>dj vius ?kj ls
lkjs pkdqvksa dks Qsduk iM+kA mudk ;g Mj fd og viuh gh csVh
dks pkdw ls ekj Mkysaxh] bruk T;knk c<+ x;k fd og ckj&ckj
fdlh u fdlh cgkus ls viuh csVh dks vius ekrk&firk ds ?kj
Hkstrh FkhA mUgksaus ekufld MkWDVjksa dh lykg rc yh tc mudh
yk[k dksfkkksa ds ckotwn ;g lksp muds dkcw esa ugha vk;h vkSj
;g lksp muds dke esa ck/kk Mkyus yxhA
20 lky dk bUthfu;fjax dk Nk=] 2 lky ls fujFkZd fopkjksa ls
ijskku gksdj vLirky vk;k FkkA og dgrk Fkk fd mls ckj&ckj
;g fopkj vkrs Fks fd vxj mlds firkth ej x, & rc D;k
gksxk] ;k firkth ds ekSr ds ckn D;k ifjorZu vk,xk] ?kj dh
vkenuh esa D;k ifjorZu vk,xk bR;kfnA ;g lkjs fopkj ,d ds
ckn ,d mlds eu esa ,d J`a[kyk esa vkrs Fks] ftlds vkf[kj esa
iqu% firkth dk e`R;q dk nq%[kn fopkj vkrk FkkA ejht dks ;g
tkudkjh Fkh fd NksVh&eksVh chekfj;ksa ds vykok muds firkth iwjh
rjg LoLFk FksA ejht dks ;dhu Fkk fd ;g fopkj okg~;kr Fks] ijarq
og muij dkcw ugha ik ldrk FkkA
24 lky ds fdlku dks ;g ijskkuh Fkh fd mUgsa cqtqxZ yksxksa vkSj
Hkxoku dks dkslus vkSj xns xkyh nsus ds fopkj vkrs FksA ;g fopkj
cqtqxZ yksxksa dks ns[kus ij] Hkxoku ds rLohj ns[kus ;k eafnj ds
ikl xqtjus ij vkrs FksA ;g fopkj muesa T;knk ?kcjkgV iSnk djrs
Fks D;ksafd og Hkxoku dks vkSj cqtqxZ yksxksa dks cgqr ekurs FksA bu
fopkjksa dks jksdus ds fy, og vius gksBksa dks dlds idM+us dh
dksfkk djrs Fks D;ksafd mUgsa Mj yxrk Fkk fd dgha og xkyh u
cd nsaA ijarq og lQy ugha gksrs FksA mUgksaus cqtqxZ yksxksa ls ckr
djuk vkSj eafnj tkuk NksM+ fn;kA og ekufld MkWDVj ds ikl
blfy, vk, D;ksafd ;g fopkj muds lgukfDr ds ckgj gks x;s
FksA
27 lky dk iq:"k] rLohjsa [khapus dk dke djrk FkkA og vLirky
blfy, vk;k D;ksafd mls ckj&ckj fnu esa gq ?kVukvksa ds n`;
fn[kk nsrs FksA mlds nwljksa ds lkFk ckrphr djus dk n`; bR;kfnA
;g n`; mls [kqkh ugha nsrk Fkk vkSj og mls csdkj ekurk FkkA
Copyright NIMHANS, 2008. Bangalore, INDIA 15

mlus buij dkcw ikus dh dksfkk dh] vius vki dks ;g crk;k
fd mls buij fopkj ugha djuk pkfg,A ijarq og lQy ugha gqvk
vkSj ;g n`; ckj&ckj vkrs jgsA
22 lky dk flD;wjVh xkMZ ;g ijskkuh ysdj vk;k Fkk fd mls
[kjkc fopkj vkrs FksA mls ckj&ckj fdlh [krjs ds ckjs esa fopkj
vkrs Fks tks mlus i<+k Fkk ;k ftls mlus jsfM;ks ij lquk FkkA ;g
fopkj ckj&ckj vkrs Fks] fcuk fdlh otg ds] tcfd og [krjk [kkl
ugha gksrk FkkA og bu fopkjksa dks jksdus dh dksfkk djrk Fkk &
vius Hkfo"; vkSj vU; ?kVukvksa ds ckjs esa lkspdjA ijarq okil]
dqN gh le; esa] ;g fopkj mls ijskku djus vk tkrs FksA

16

Obsessive-compulsive disorder (OCD) is a common and disabling mental disorder. It is

twice as common as schizophrenia and bipolar disorder. OCD is largely underdiagnosed
and inadequately treated. OCD mostly presents for the first time in adolescence and can
thus incapacitate a person throughout his/her life. Despite its relatively early age at onset,
only a minority of sufferers receive treatment early in the course of illness. OCD also has
its relative share of stigma, resulting in long delays in treatment. This is compounded by the
fact that most medical professionals are unfamiliar with its clinical characteristics resulting
in delay in diagnosis and appropriate treatment.
Considerable progress has occurred in the last two decades in the treatment and understanding of this common psychiatric illness. Serotonin reuptake inhibitors and cognitive behavior
therapy, both have improved the outcome of this illness, which was otherwise considered
difficult to treat. There is also significant advance in the understanding of the neurobiology
of OCD with respect to neural correlates of obsessional behavior, genetics and immunology. However, despite the advances in understanding the neurobiology and the cognitive
factors in the causation of OCD and availability of effective treatments, about 40% to 60%
of the patients do not show satisfactory improvement. This shows that there is still much to
be understood
The OCD clinic was started on the 24 of June, 1997 by Dr. Sumanth Khanna and Dr. YC
Janardhan Reddy, with the objective of providing clinical services, training mental health
professionals and conducting research. The OCD clinic at NIMHANS is very popular and
caters to around 120 to 150 new patients per year and follows up close to 1000 patients in a
year. Patients are often referred from across the country for management of resistant OCD.
The specialty OCD clinic is also known for its research activities and have published many
international articles. Research activities are focused on phenomenology, course and outcome studies, family studies, genetics, neuroimaging, and neuropsychological studies. This
specialty clinic held an international symposium on Nov 10 & 11, 2007 in commemoration
of completion of a decade of specialty OCD services at the National Institute of Mental
Health and Neuro Sciences (NIMHANS), Bangalore