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

Summary & key facts

Researchers asked 100 people with obsessive-compulsive disorder in an outpatient clinic about when their symptoms started, when they were diagnosed, and when they began treatment. On average people first noticed symptoms at about 19 years old. It then took roughly 13 years for them to get a correct diagnosis, and another 1.5 years on average to start treatment after diagnosis. The study found that people who were diagnosed sooner tended to have started symptoms later in life, had milder symptoms, better daily functioning, and felt less shame about their condition. The authors say these long delays are still a problem and that cutting the time to diagnosis and to the start of therapy could help, while noting the study used self-reports from one clinic and cannot prove cause and effect.

Key facts:

• The study asked 100 people with obsessive-compulsive disorder in an outpatient clinic about their symptom history and care.
• People reported first OCD symptoms at about 19 years old on average.
• On average it took about 13 years from when people first noticed symptoms to when they were correctly diagnosed.
• After diagnosis, people waited about 1.5 years on average before beginning therapy.
• People who were diagnosed within 7 years of symptom start were younger now, had begun symptoms at an older age, had less severe OCD symptoms, worked and managed daily life better, and felt less self-stigma than those who waited 7 years or more for diagnosis.
• The study relied on people’s memories and was done in a single clinic, so the results can’t prove what caused the delays and might not apply everywhere.

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 According to existing outdated literature, this study aimed to investigate the current duration between symptom onset and diagnosis and between diagnosis and the beginning of therapy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.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Obsessive-Compulsive Spectrum Disorders Personality Disorders and Psychopathology

Categories

Clinical Psychology Psychology Social Sciences

Tags

Age of onset Disease Internal medicine Medicine Pediatrics Psychiatry Retrospective cohort study Young adult

Conditions & symptoms

Obsessive-Compulsive Disorder Anxiety or worry