Abstract

BackgroundObsessive-compulsive disorder (OCD) is a serious mental health problem that causes significant impairment and reduced quality of life. Though some substantially benefit from psychological therapies, a substantial proportion of people with OCD disengage from treatment or fail to benefit. Theoretical models such as the Common-Sense Model posit that our management of physical illness depends on our perceptions about the condition. Identifying how people with OCD perceive their condition could lead to important insight that would improve treatment of OCD.ObjectivesTo identify and characterise the illness perceptions of people with OCD.MethodTranscribed semi-structured interviews exploring the illness perceptions of 16 people with OCD were analysed using thematic analysis.ResultsIn some cases, identification of symptoms was hindered by a failure to interpret experiences as ‘symptoms’. Instead, these individuals interpreted symptoms as a personality quirk, or as evidence that they had become deviant. Perceptions of the condition as ‘part’ of the self contributed to views of OCD as permanent. Individuals were concerned about the impact of OCD on friends and family and attempted to minimise its consequences, for example by concealing symptoms from their children, who they feared could acquire OCD.ConclusionApplying a theoretical model of physical health understanding to OCD yielded novel insights, with important implications for support and treatment. To enable early help-seeking and rapid diagnosis, public and professional knowledge about OCD should be extended beyond ‘washing and checking’ to the less widely known OCD-subtypes, such as fear of causing harm. It may be important to identify and challenge views of OCD as permanent early in the course of treatment to maximise engagement. Management of OCD should also address the burden of living with OCD in a family context. Further research to test whether these perceptions lead to coping responses and outcomes in OCD is now needed.

Highlights

  • Obsessive-compulsive disorder (OCD) is a mental health condition that affects approximately 2% of the population in their lifetime [1, 2]

  • Management of OCD should address the burden of living with OCD in a family context

  • Further research to test whether these perceptions lead to coping responses and outcomes in OCD is needed

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Summary

Introduction

Obsessive-compulsive disorder (OCD) is a mental health condition that affects approximately 2% of the population in their lifetime [1, 2]. The CSM posits that an individual’s behavioural responses and attempts to regulate a given health threat depend on their cognitive ‘representation’ of that threat (i.e. their ‘illness perceptions’; IP)[9, 10] This representation comprises perceptions about the identity, consequences, causes, timeline and controllability of the illness [10]. Obsessive-compulsive disorder (OCD) is a serious mental health problem that causes significant impairment and reduced quality of life. Though some substantially benefit from psychological therapies, a substantial proportion of people with OCD disengage from treatment or fail to benefit Theoretical models such as the Common-Sense Model posit that our management of physical illness depends on our perceptions about the condition.

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