Stress situations of daily living in patients with obsessive-compulsive disorder: a retrospective case note study

About 40% of patients with obsessive-compulsive disorder (OCD) are said to have treatment-refractory symptoms and chronic course of illness in spite of cognitive-behavior therapy and pharmacotherapy. The present purpose was to investigate factors relevant to OCD patients' chronic course and disturbed daily functions in view of human basic needs based on Maslow's hierarchy of five basic needs. Case notes of 101 outpatients with OCD (47 men and 54 women who were 18 to 55 years old) and seen on a psychiatry unit of a general hospital were studied to explore their stressful situations and identify thwarted basic needs. 84 of the 101 patients had Love Needs, and Esteem Needs (n = 47) and Safety Needs (n = 45) were next. The Poor-functioning group mainly had histories with problems of Safety Needs (70.8%), while the Good-functioning group tended to mainly have problems of Esteem Needs (51.5%) rather than Safety Needs (33.3%). 57 patients (23 men and 34 women) who were treated for more than three months were divided into two groups according to their Global Assessment of Functioning score at the final assessment (cut-off point: 61); patients in the Good-functioning group tended to have problems of higher needs.