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.

Conclusion:The presence of a DSM-IV mental disorder was associated with a 44% higher risk of having experienced a cold in the past 12 months. Further studies are needed to explore potential common risk factors for incidence of mental disorders and the common cold, since the pathway connecting them has not been fully determined.

No abstract