Obsessive-Compulsive Disorder Often Is Unrecognized

Obsessive-compulsive disorder (OCD), a distressing and disabling condition, frequently is overlooked or incorrectly diagnosed in primary care. OCD is marked by intrusive, recurrent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). In a worthwhile review article, authors focus on underdiagnosis of OCD and offer the following observations:

• Because OCD symptoms vary widely (from contamination fears and checking behaviors to intrusive aggressive or sexual thoughts), the disorder is difficult to recognize.

• Diagnosis often is delayed (mean time between symptom onset and diagnosis, 7 years), and diagnosis can take even longer in the 50% of people with childhood onset.

• Shame, stigma, and family accommodation to sympto…