Obsessive-compulsive disorder in the World Mental Health surveys

Area of Science:

• Psychiatry
• Epidemiology
• Global Mental Health

Background:

• Obsessive-compulsive disorder (OCD) is recognized as a significant mental health condition, yet cross-national data, particularly from low- and middle-income countries (LMICs), are limited.
• Existing national surveys indicate OCD's prevalence and impairing nature, highlighting the need for broader international research.

Purpose of the Study:

• To characterize the onset, course, severity, and treatment of OCD across diverse countries using data from the World Mental Health surveys.
• To investigate predictors of OCD onset, persistence, severity, and treatment, including socio-demographic variables and prior mental disorders.

Main Methods:

• Utilized data from general population surveys in 10 countries, employing a consistent research protocol and face-to-face interviews with 26,136 adults.
• Assessed lifetime and 12-month prevalence, age of onset, persistence, severity (using Yale-Brown Obsessive-Compulsive Scale), and treatment rates for DSM-IV OCD.
• Examined socio-demographic factors and preceding mental disorders as potential predictors.

Main Results:

• The combined lifetime prevalence of OCD across 10 countries was 4.1%, with a 12-month prevalence of 3.0%, indicating a persistent course.
• OCD typically emerges in adolescence or early adulthood (over 80% of cases), with most community cases being mild to moderate.
• Treatment rates were low overall (19.8%), significantly lower in LMICs (7.0%) compared to high-income countries (HICs) (40.5%).

Conclusions:

• Cross-national data reveal OCD as a prevalent and persistent disorder, often beginning early in life and frequently undertreated, particularly in LMICs.
• Emphasizes the public health significance of OCD and the need for early diagnosis, comprehensive comorbidity assessment, and improved treatment access.
• Highlights distinct socio-demographic and psychopathological risk factors for OCD onset, persistence, severity, and treatment across different countries.