Obsessive–compulsive disorder in the community: 12-month prevalence, comorbidity and impairment

Abstract

Background Although subthreshold conditions are associated with impairment in numerous disorders, research on obsessive-compulsive disorder (OCD) below the diagnostic threshold of DSM-IV in the general population is limited. Purpose To estimate the DSM-IV 12-month prevalence, comorbidity and impairment of OCD, subthreshold OCD (i.e., fulfilling some but not all core DSM-IV criteria), and obsessive-compulsive symptoms (OCS) (i.e., endorsement of OCS without fulfilling any core DSM-IV criteria) in a general population sample. Methods Data from the German National Health Interview and Examination Survey-Mental Health Supplement (N = 4181, age 18-65 years), based on the standardized diagnostic Munich Composite International Diagnostic Interview. Results The 12-month prevalence of OCD was 0.7%, subthreshold OCD was 4.5%, and OCS was 8.3%. Subjects in all three groups showed higher comorbidity (odds ratios [ORs] C 3.3), compared to those without OCS. The OCD, subthreshold OCD and OCS were all associated with increased odds of substance abuse/dependence-, mood-, anxiety-and somatoform disorders, with especially strong associations with possible psychotic disorder (ORs C 4.1) and bipolar disorders (ORs C 4.7). Participants in all three groups showed higher impairment (ORs C 3.1) and healthcare utilization (ORs C 2.4), compared to those without OCS, even after controlling for covariates. Conclusions Individuals with subthreshold OCD and OCS, not currently captured by DSM-IV OCD criteria, nevertheless show substantial comorbidity, impairment and health-care utilization. This should be taken into account in future conceptualization and classification of OCD and clinical care.

Obsessive-Compulsive Symptoms in Medical Students: Prevalence, Severity, and Correlates

“…Given that OCS are not exclusive to OCD, occurring even in people without any psychiatric disorder, recent community surveys [20,[38][39][40] have adopted a dimensional approach to evaluate the occurrence of OCS, including subclinical manifestations, rather than a categorical view (i.e., presence or absence of OCD diagnosis).…”

The prevalence and predictors of comorbid bipolar disorder and obsessive–compulsive disorder: A systematic review and meta-analysis

“…Among BD study populations, studies that only focused on BD-I, BD-II or BD Non Otherwise Specified (Angst et al, 2004) were included. Studies that considered subjects with bipolar and obsessive-compulsive spectrums were also included if diagnostic criteria used were specified (Angst et al, 2004, Adam et al, 2012. Participants of both sexes older than 6 years of age were considered.…”

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

“…Two populationbased studies conducted, respectively, in USA and Germany, reported 6% and 10% of lifetime prevalence of comorbid BD in OCD adults (46,47) and 5% in OCD children and adolescents (46). Using the bipolar spectrum concept in the general population (48), a study reported 53.3% and 30% of BD-OCD and BD-II-OCD patients respectively (15).…”