Abstract
Background
Several studies have described the deficits in the health care provided to persons with obsessive–compulsive disorder (OCD), however, without making any distinction between psychiatric–psychotherapeutic professionals and general practitioners or other professionals. Also, the relation between subjectively defined early signs of the disorder, diagnosis and utilization of professional help has not yet been investigated systematically. The present study addresses these questions, using a self-rating questionnaire for patients with OCD (questionnaire on the utilization of professional help by patients with OCD).
Methods
Eighty-eight patients with OCD, who came to our University Hospital Outpatient Clinic for obsessive–compulsive disorders in Leipzig, participated in the study. The questionnaire, which had been developed specially for this survey, asked study participants to remember when they had first perceived signs of their disorder and their first-time utilization of professional help.
Results
Patients with OCD and early onset of disorder sought professional help later than did patients with later onset of disorder. When professional help was utilized, it took 2 years on average before the diagnosis was made. Patients with OCD first consulted a psychiatrist or psychotherapist and not the general practitioner as their first professional contact person.
Conclusion
First signs in the early stages of OCD, particularly with an onset in childhood and adolescence have to be diagnosed at an earlier stage for appropriate treatment. Psychiatrists and psychotherapists, not primarily general practitioners, have a particularly high demand for further education about early diagnosis and treatment of OCD.
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Notes
GDR = former German Democratic Republic, all children went to Polytechnic School (POS; grade 1–10).
References
Bebbington PE (1998) Epidemiology of obsessive–compulsive disorder. Br J Psychiatry Suppl 35:2–6
Lopez AD, Murray CC (1998) The global burden of disease: 1990–2020. Nat Med 4:1241–1243
Stengler-Wenzke K, Kroll M, Matschinger H, Angermeyer MC (2006) Subjective quality of life of patients with obsessive–compulsive disorder. Soc Psychiatry Psychiatr Epidemiol 41:662–668
Beiser M, Erickson D, Fleming JA, Iacono WG (1993) Establishing the onset of psychotic illness. Am J Psychiatry 150:1349–1354
Häfner H, Riecher-Rössler A, Hambrecht M, Maurer K, Meissner S, Schmidtke A, Fätkenheuer B, Löffler W, van der Heiden W (1992) IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophr Res 6:209–223
McGorry PD, Yung AR (2003) Early intervention in psychosis: an overdue reform. Aust N Z J Psychiatry 37:393–398
Lewinsohn PM, Pettit JW, Joiner TE Jr, Seeley JR (2003) The symptomatic expression of major depressive disorder in adolescents and young adults. J Abnorm Psychol 112:244–252
Keller MB (2003) The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatr Scand Suppl 417:85–94
Wittchen HU, Fehm L (2003) Epidemiology and natural course of social fears and social phobia. Acta Psychiatr Scand Suppl 417:4–18
Rasmussen SA, Eisen JL (1992) The epidemiology and clinical features of obsessive compulsive disorder. Psychiatr Clin North Am 15:743–758
Grabe HJ, Meyer C, Hapke U, Rumpf HJ, Freyberger HJ, Dilling H, John U (2000) Prevalence, quality of life and psychosocial function in obsessive–compulsive disorder and subclinical obsessive–compulsive disorder in northern Germany. Eur Arch Psychiatry Clin Neurosci 250:262–268
Skoog G, Skoog I (1999) A 40-year follow-up of patients with obsessive–compulsive disorder. Arch Gen Psychiatry 56:121–127
Angst J, Gamma A, Endrass J, Goodwin R, Ajdacic V, Eich D, Rossler W (2004) Obsessive–compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch Psychiatry Clin Neurosci 254:156–164
Monti M, Sambvani N, Sacrini F (1998) Obsessive–compulsive disorders in dermatology. J Eur Acad Dermatol Venereol 11:103–108
Fineberg NA, O’Doherty C, Rajagopal S, Reddy K, Banks A, Gale TM (2003) How common is obsessive–compulsive disorder in a dermatology outpatient clinic? J Clin Psychiatry 64:152–155
Greist JH, Bandelow B, Hollander E, Marazziti D, Montgomery SA, Nutt DJ, Okasha A, Swinson RP, Zohar J (2003) World Council of Anxiety. WCA recommendations for the long-term treatment of obsessive–compulsive disorder in adults. CNS Spectr 8:7–16
Stengler-Wenzke K, Angermeyer MC (2005) Employment of professional help by patients with obsessive–compulsive disorders. Psychiatr Prax 32:195–201
Goodwin R, Koenen KC, Hellman F, Guardino M, Struening E (2002) Helpseeking and access to mental health treatment for obsessive–compulsive disorder. Acta Psychiatr Scand 106:143–149
Besiroglu L, Cilli AS, Askin R (2004) The predictors of health care seeking behavior in obsessive–compulsive disorder. Compr Psychiatry 45:99–108
Lomax CL, Oldfield VB, Salkovskis PM (2009) Clinical and treatment comparisons between adults with early- and late-onset obsessive–compulsive disorder. Behav Res Ther 47:99–104
Jaisoorya TS, Janardhan Reddy YC, Srinath S (2003) Is juvenile obsessive–compulsive disorder a developmental subtype of the disorder?–Findings from an Indian study. Eur Child Adolesc Psychiatry 12:290–297
Fontenelle LF, Mendlowicz MV, Marques C, Versiani M (2003) Early- and late-onset obsessive–compulsive disorder in adult patients: an exploratory clinical and therapeutic study. J Psychiatr Res 37:127–133
Sobin C, Blundell ML, Karayiorgou M (2000) Phenotypic differences in early- and late-onset obsessive–compulsive disorder. Compr Psychiatry 41:373–379
Saß H, Wittchen HU, Zaudig M (2000) Diagnostic and statistical manual of mental disorders, 4th revision (DSM-IV). American Psychiatric Association, USA (German version: (2003) DSM-IV—Diagnostisches und Statistisches Manual psychischer Störungen. Hogrefe-Verlag)
Micali N, Heyman I, Perez M, Hilton K, Nakatani E, Turner C, Mataix-Cols D (2010) Long-term outcomes of obsessive–compulsive disorder: follow-up of 142 children and adolescents. Br J Psychiatry 197:128–134
Dezetter A, Briffault X, Bruffaerts R, De Graaf R, Alonso J, König HH, Haro JM, De Girolamo G, Vilagut G, Kovess-Masfety V (2012) Use of general practitioners versus mental health professionals in six European countries: the decisive role of the organization of mental health systems. Soc Psychitry Psychiatr Epidemiol. doi:10.1007/s00127-012-0522-9
Wittchen HU, Kessler RC, Beesdo K, Krause P, Höfler M, Hoyer J (2002) Generalized anxiety and depression in primary care: prevalence, recognition, and management. J Clin Psychiatry 63:24–34
WHO (1992) International statistical classification of diseases and related health problems, 10th revision (ICD 10). WHO, Geneva
Wittchen HU, Semmler G (1990) Composite international diagnostic interview—CIDI (Deutsche version). Beltz Verlag, Weinheim
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS (1989) The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 46:1006–1011
Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS (1989) The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry 46:1012–1016
Deacon BJ, Abramowitz JS (2005) The Yale-Brown Obsessive Compulsive Scale: factor analysis, construct validity, and suggestions for refinement. J Anxiety Disord 19:573–585
Millet B, Kochman F, Gallarda T, Krebs MO, Demonfaucon F, Barrot I, Bourdel MC, Olie JP, Loo H, Hantouche EG (2004) Phenomenological and comorbid features associated in obsessive–compulsive disorder: influence of age of onset. J Affect Disord 79:241–246
Rosario-Campos MC, Leckman JF, Mercadante MT, Shavitt RG, Prado HS, Sada P, Zamignani D, Miguel EC (2001) Adults with early-onset obsessive–compulsive disorder. Am J Psychiatry 158:1899–1903
Delorme R, Golmard JL, Chabane N, Millet B, Krebs MO, Mouren-Simeoni MC, Leboyer M (2005) Admixture analysis of age at onset in obsessive–compulsive disorder. Psychol Med 35:237–243
de Mathis MA, Diniz JB, Shavitt RG, Torres AR, Ferrão YA, Fossaluza V, Pereira C, Miguel E, do Rosario MC (2009) Early onset obsessive–compulsive disorder with and without tics. CNS Spectr 14:362–370
Mataix-Cols D, Rosario-Campos MC, Leckman JF (2005) A multidimensional model of obsessive–compulsive disorder. Am J Psychiatry 162:228–238
Miguel EC, Leckman JF, Rauch S, do Rosario-Campos MC, Hounie AG, Mercadante MT, Chacon P, Pauls DL (2005) Obsessive–compulsive disorder phenotypes: implications for genetic studies. Mol Psychiatry 10:258–275
Fontenelle LF, Hasler G (2008) The analytical epidemiology of obsessive–compulsive disorder: risk factors andcorrelates. Prog Neuropsychopharmacol Biol Psychiatry 32:1–15
Lochner C, Stein DJ (2003) Heterogeneity of obsessive–compulsive disorder: a literature review. Harv Rev Psychiatry 11:113–132
Wewetzer C, Jans T, Müller B, Neudörfl A, Bücherl U, Remschmidt H, Warnke A, Herpertz-Dahlmann B (2001) Long-term outcome and prognosis of obsessive–compulsive disorder with onset in childhood or adolescence. Eur Child Adolesc Psychiatry 10:37–46
Eichstedt JA, Arnold SL (2001) Childhood-onset obsessive–compulsive disorder: a tic-related subtype of OCD? Clin Psychol Rev 21:137–157
Essau CA, Conradt J, Petermann F (2002) Course and outcome of anxiety disorders in adolescents. J Anxiety Disord 16:67–81
Bloch MH, Craiglow BG, Landeros-Weisenberger A, Dombrowski PA, Panza KE, Leckman JF, Peterson BS (2009) Predictors of early adult outcomes in pediatric-onset obsessive–compulsive disorder. Pediatrics 124:1085–1093
Walitza S, Wendland JR, Gruenblatt E, Warnke A, Sontag TA, Tucha O, Lange KW (2010) Genetics of early-onset obsessive–compulsive disorder. Eur Child Adolesc Psychiatry 19:227–235
Nestadt G, Samuels J, Riddle MA, Liang KY, Bienvenu OJ, Hoehn-Saric R, Grados M, Cullen B (2001) The relationship between obsessive–compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study. Psychol Med 31:481–487
Janowitz D, Grabe HJ, Ruhrmann S, Ettelt S, Buhtz F, Hochrein A, Schulze-Rauschenbach S, Meyer K, Kraft S, Ferber C, Pukrop R, Freyberger HJ, Klosterkötter J, Falkai P, John U, Maier W, Wagner M (2009) Early onset of obsessive–compulsive disorder and associated comorbidity. Depress Anxiety 26:1012–1017
Wahl K, Kordon A, Kuelz KA, Voderholzer U, Hohagen F, Zurowski B (2010) Obsessive–compulsive disorder (OCD) is still an unrecognised disorder: a study on the recognition of OCD in psychiatric outpatients. Eur Psychiatry 25:374–377
Külz AK, Hassenpflug K, Riemann D, Linster HW, Dornberg M, Voderholzer U (2010) Psychotherapeutic care in OCD outpatients—results from an anonymous therapist survey. Psychother Psychosom Med Psychol 60:194–201
Möller-Leimkühler AM (2000) Men and depression: gender-related help-seeking behavior. Fortschr Neurol Psychiatr 68:489–495
Rochlen AB, Paterniti DA, Epstein RM, Duberstein P, Willeford L, Kravitz RL (2010) Barriers in diagnosing and treating men with depression: a focus group report. Am J Mens Health 4:167–175
Stengler-Wenzke K, Kroll M, Matschinger H, Angermeyer MC (2006) Quality of life of relatives of patients with obsessive–compulsive disorder. Compr Psychiatry 47:523–527
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Stengler, K., Olbrich, S., Heider, D. et al. Mental health treatment seeking among patients with OCD: impact of age of onset. Soc Psychiatry Psychiatr Epidemiol 48, 813–819 (2013). https://doi.org/10.1007/s00127-012-0544-3
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DOI: https://doi.org/10.1007/s00127-012-0544-3