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  • Title: Obsessive-compulsive disorder in the community: 12-month prevalence, comorbidity and impairment.
    Author: Adam Y, Meinlschmidt G, Gloster AT, Lieb R.
    Journal: Soc Psychiatry Psychiatr Epidemiol; 2012 Mar; 47(3):339-49. PubMed ID: 21287144.
    Abstract:
    BACKGROUND: Although subthreshold conditions are associated with impairment in numerous disorders, research on obsessive-compulsive disorder (OCD) below the diagnostic threshold of DSM-IV in the general population is limited. PURPOSE: To estimate the DSM-IV 12-month prevalence, comorbidity and impairment of OCD, subthreshold OCD (i.e., fulfilling some but not all core DSM-IV criteria), and obsessive-compulsive symptoms (OCS) (i.e., endorsement of OCS without fulfilling any core DSM-IV criteria) in a general population sample. METHODS: Data from the German National Health Interview and Examination Survey-Mental Health Supplement (N = 4181, age 18-65 years), based on the standardized diagnostic Munich Composite International Diagnostic Interview. RESULTS: The 12-month prevalence of OCD was 0.7%, subthreshold OCD was 4.5%, and OCS was 8.3%. Subjects in all three groups showed higher comorbidity (odds ratios [ORs] ≥ 3.3), compared to those without OCS. The OCD, subthreshold OCD and OCS were all associated with increased odds of substance abuse/dependence-, mood-, anxiety- and somatoform disorders, with especially strong associations with possible psychotic disorder (ORs ≥ 4.1) and bipolar disorders (ORs ≥ 4.7). Participants in all three groups showed higher impairment (ORs ≥ 3.1) and health-care utilization (ORs ≥ 2.4), compared to those without OCS, even after controlling for covariates. CONCLUSIONS: Individuals with subthreshold OCD and OCS, not currently captured by DSM-IV OCD criteria, nevertheless show substantial comorbidity, impairment and health-care utilization. This should be taken into account in future conceptualization and classification of OCD and clinical care.
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