Long durations from symptom onset to diagnosis and from diagnosis to treatment in obsessive-compulsive disorder: A retrospective self-report study

Abstract

Background Although obsessive-compulsive disorder (OCD) is one of the most common mental disorders, it takes up to 17 years for patients with OCD to receive adequate therapy. According to existing outdated literature, this study aimed to investigate the current duration between symptom onset and diagnosis and between diagnosis and the beginning of therapy separately. Methods In a cross-sectional study, N = 100 patients diagnosed with OCD undergoing treatment in a psychiatric outpatient department were assessed, using self-report questionnaires on sociodemographic and clinical variables. Based on self-reported information, the durations between age at symptom onset and age at diagnosis, and between age at diagnosis and beginning of therapy were calculated. To investigate associated factors, two subgroups of patients, one with a short duration between symptom onset and diagnosis < 7 years, and another with a long duration between symptom onset and diagnosis ≥ 7 years, respectively, were compared. Results and conclusion Patients reported first symptoms of OCD at a mean age of 18.72 years. The mean duration between age at symptom onset and age at diagnosis was 12.78 years and the mean duration between age at diagnosis and the beginning of therapy was 1.45 years. Subgroup comparison indicated that patients with a short duration between symptom onset and diagnosis were significantly younger than patients with a long duration. However, patients with a short duration between symptom onset and diagnosis were at an older age when they reported first symptoms of OCD. Further, they showed less severe symptoms of OCD, higher functioning levels, and less self-stigmatization than patients with a long duration. It can be concluded that the duration until patients with OCD are diagnosed correctly and receive adequate treatment is still very long. Therefore, the duration between symptom onset and diagnosis should be shortened. Further, the duration between diagnosis and the beginning of therapy could be a good additional approach to reduce the overall duration of untreated disorder.

Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder

“…Although no significant association was found between OCD-DTI and all aspects of wellbeing studied, this result encourages further clinical reflection. It is worse compared to the results obtained many years ago by Hollander et al (33) and similar to Ziegler et al (34). It may mean that despite the unquestionably improved access to medical knowledge and psychiatric treatment, OCD is still an embarrassing and hidden disorder.…”

“…For treatment-resistant OCD, psychosurgical techniques (capsulotomy, cingulotomy) are permitted, which is an extraordinary treatment in the field of psychiatry ( 31 , 32 ). OCD delayed treatment initiation (OCD-DTI), which is 10 years according to Hollander et al ( 33 ) and up to 13 years according to Ziegler et al ( 34 ) is another problem ( 33 , 34 ). Obsessions that may extend OCD-DTI include ego-syntonic obsessions and, most often, symmetry obsessions and compulsive ordering and counting ( 29 ).…”

Obsessive-Compulsive Disorder: A Medical School Curriculum and Textbook Review

“…Conversely, underdetection of OCD can result in individuals failing to receive evidence-based treatments, such as antidepressant medication or exposure and response prevention therapy. 55 On average, it takes nearly 13 years between the onset of OCD symptoms and receiving a diagnosis, 56 and even then, individuals with OCD rarely receive firstline treatments. 57 A longer duration of untreated OCD is significantly associated with a higher risk of developing comorbid general medical conditions (eg, metabolic, gastrointestinal, and cardiovascular diseases).…”

Stable through the COVID-19 pandemic: Results from a longitudinal telephone interview study in psychiatric outpatients

“…In particular, regarding the diagnosis of ADHD and OCD in adults, there is a need for awareness on the part of treatment providers. There is still a discrepancy between the prevalences resulting from epidemiological studies and the prevalence of actual ADHD and OCD diagnoses (e.g., [ 45 , 46 ]). Since the clinic at which the survey was conducted has specializations in this area, these diagnoses occur more frequently in the sample studied than in other samples of psychiatric outpatients.…”