OCD in Women: Diagnosis and Magnitude

Abstract

KeyDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for obsessive-compulsive disorder (OCD) include the presence of either obsessions or compulsions, some recognition by the individual that their symptoms are excessive or irrational (except in children), duration of at least 1 hour/day, and association with marked distress or functional impairment. OCD patients report that somatic, religious, and sexual obsessions as well as those concerning contamination, aggression, symmetry, and hoarding are most common. The most frequent compulsions reported in OCD patients involve checking, cleaning, counting, repeating, and hoarding behaviors. Factor analyses of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist have also identified five primary symptom dimensions: aggression/checking; contamination/cleaning; symmetry/repeating, counting, or ordering rituals; hoarding; and a sexual/religious symptom dimension.Results from a large, 2-year prospective study suggest that symptoms of adult OCD are much more stable than previously thought, with any changes more likely to occur within, rather than between the symptom dimensions. Prevalence estimates based on the Epidemiologic Catchment Area survey and the Cross-National OCD Collaborative Group study indicate a worldwide lifetime prevalence rate for OCD of 2% to 3%. Females have a slightly higher risk (1.5 times) for OCD (Slide I). OCD onset is relatively early, generally during adolescence or young adulthood. The clinical course of OCD is generally chronic and complicated by comorbidities.