Integrative Management of Atattvabhinivesha (Obsessive-Compulsive Disorder): A Comprehensive Case Report and Conceptual Analysis

Abstract

In Ayurveda nosology, a correlate condition called Atattvabhinivesha is classified as a Mahagada and involves derangement of the intellect (Buddhi) and mind (Manas) due to vitiated Rajas and Tamas. Objective: This case report aims to examine the clinical efficacy of a multimodal Ayurveda treatment regimen by posing the central question: Can this combination of Yukti Vyapashraya (rational therapy) and Satvavajaya (Ayurveda psychotherapy) reduce Y-BOCS scores by at least 35% within six weeks? This research targets a 33-year-old male diagnosed with Atattvabhinivesha (OCD) and exhibiting signs of somatic Pitta aggravation, aiming to illuminate the pharmacodynamic mechanisms involved. Methods: A 33-year-old male with a five-year history of contamination obsessions, perfectionism, and somatic symptoms such as abdominal burning and headaches was evaluated. Diagnosis of Atattvabhinivesha was established using Charaka Samhita criteria, and OCD was confirmed according to DSM-5. The therapeutic regimen included internal administration of Sutshekhar Rasa, Samsamani Vati, and Stri Rasayana No. 2 for its adaptogenic properties, in conjunction with structured Satvavajaya Chikitsa. Clinical outcomes were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: The patient demonstrated a significant reduction in symptom severity, as evidenced by a decrease in Y-BOCS scores from 25 (Severe) to 12 (Mild). Resolution of somatic symptoms, including headache and abdominal pain, was observed, pointing to likely restoration of the gastrointestinal-neural connection. Conclusion: Atattvabhinivesha serves as a robust clinical model for OCD within the Ayurveda framework. The observed therapeutic benefits underline the importance of Pitta-pacifying mineral formulations and Medhya Rasayanas for neurocognitive and metabolic modulation, supporting the use of Ayurveda protocols to improve outcomes in treatment-resistant cases.