Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T09:10:36.280Z Has data issue: false hasContentIssue false
  • English
  • Français

Duration of untreated illness in a cross-diagnostic sample of obsessive-compulsive disorder, panic disorder, and social anxiety disorder

Published online by Cambridge University Press:  13 November 2018

Paula Vigne ,
Pedro Fortes ,
Rafaela V. Dias ,
Luana D. Laurito ,
Carla P. Loureiro ,
Gabriela B. de Menezes ,
Ulrich Stangier  and
Leonardo F. Fontenelle
Paula Vigne
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Pedro Fortes
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Rafaela V. Dias
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Luana D. Laurito
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Carla P. Loureiro
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Gabriela B. de Menezes
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
Ulrich Stangier
Affiliation:
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Frankfurt, Frankfurt, Germany
Leonardo F. Fontenelle*
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia D’Or Institute for Research and Education, Rio de Janeiro, Brazil
*
*Address correspondence to: Leonardo F. Fontenelle, Rua Visconde de Pirajá, 547, 617 Ipanema, Rio de Janeiro-RJ, Brazil, CEP: 22410-003. (E-mail: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

In this study, we compared duration of untreated illness (DUI) in obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD) patients and investigated its correlates, both within specific diagnoses and across the whole sample.

Methods

Eighty-eight patients (33 OCD, 24 SAD, and 31 PD) had their diagnosis confirmed by the Mini International Neuropsychiatric Interview, were assessed for treatment-seeking variables, and were evaluated with instruments aimed at quantifying transdiagnostic features (i.e., the Cause subscale of the Illness Perception Questionnaire–Mental Health and the Anxiety Sensitivity Index–Revised) and severity of illness (i.e., Beck Depression and Anxiety Inventories, the Dimensional Obsessive-Compulsive Scale, the Panic and Agoraphobia Scale, and the Social Phobia Inventory).

Results

The only differences between groups with short (<2 years) versus long (>2 years) DUI were greater fear of public display of anxiety in the first group and greater social avoidance in the second group. The DUI was significantly different between groups that sought treatment after the onset of illness, with OCD patients having longer DUI than PD patients and shorter DUI than SAD patients. Further, DUI correlated negatively with the perception of OCD being caused by stress and positively with severity of panic-related disability in SAD patients, but not in PD or OCD patients.

Conclusion

There was substantial delay in treatment seeking among the anxiety and obsessive-compulsive disorder patients, particularly those with OCD or SAD. Perception of stress as a cause of OCD prompted treatment seeking, while severity of panic symptoms delayed treatment seeking.

Keywords

Duration of untreated illnesshelp-seekingobsessive–compulsive disorderpanic disordersocial anxiety disorder
Type
Original Research
Information
CNS Spectrums , Volume 24 , Issue 5 , October 2019 , pp. 526 - 532
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This work was supported by the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (L.F., grant numbers 201.305/2014 and 211.191/2015); Conselho Nacional de Desenvolvimento Científico e Tecnológico (L.F., grant number 308237/2014-5); D'Or Institute for Research and Education (L.F.) and the David Winston Turner Endowment Fund (L.F.).

References

Murru, A, Carpiniello, B. Duration of untreated illness as a key to early intervention in schizophrenia: a review. Neurosci Lett. 2018; 669: 59–67.CrossRefGoogle ScholarPubMed
Altamura, AC, Camuri, G, Dell’Osso, B. Duration of untreated illness and duration of illness in anxiety disorders: assessment and influence on outcome. Mod Trends Pharmacopsychiatry. 2013; 29: 111–118.CrossRefGoogle Scholar
Dell’Osso, B, Benatti, B, Oldani, L, et al. Differences in duration of untreated illness, duration, and severity of illness among clinical phenotypes of obsessive-compulsive disorder. CNS Spectr. 2015; 20(5): 474–478.CrossRefGoogle ScholarPubMed
Dell’Osso, B, Buoli, M, Hollander, E, Altamura, AC. Duration of untreated illness as a predictor of treatment response and remission in obsessive-compulsive disorder. World J Biol Psychiatry. 2010; 11(1): 59–65.CrossRefGoogle ScholarPubMed
Dell’Osso, B, Camuri, G, Benatti, B, et al. Differences in latency to first pharmacological treatment (duration of untreated illness) in anxiety disorders: a study on patients with panic disorder, generalized anxiety disorder and obsessive-compulsive disorder. Early Interv Psychiatry. 2013; 7(4): 374–380.CrossRefGoogle Scholar
Poyraz, CA, Turan, S, Saglam, NG, et al. Factors associated with the duration of untreated illness among patients with obsessive compulsive disorder. Compr Psychiatry. 2015; 58: 88–93.CrossRefGoogle ScholarPubMed
Altamura, AC, Santini, A, Salvadori, D, Mundo, E. Duration of untreated illness in panic disorder: a poor outcome risk factor? Neuropsychiatr Disease Treat. 2005; 1(4): 345–347.Google ScholarPubMed
Dalrymple, KL, Zimmerman, M. Treatment-seeking for social anxiety disorder in a general outpatient psychiatry setting. Psychiatry Res. 2011; 187(3): 375–381.CrossRefGoogle Scholar
Ertekin, E, Celebi, F, Koyuncu, A, et al. Predictors of early or late treatment seeking in patients with social anxiety disorder. Ann Clin Psychiatry. 2015; 27(4): 236–241.Google ScholarPubMed
Wagner, R, Silove, D, Marnane, C, Rouen, D. Delays in referral of patients with social phobia, panic disorder and generalized anxiety disorder attending a specialist anxiety clinic. J Anxiety Disord. 2006; 20(3): 363–371.CrossRefGoogle ScholarPubMed
Benatti, B, Camuri, G, Dell’Osso, B, et al. Which factors influence onset and latency to treatment in generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder? Int Clin Psychopharmacol. 2016; 31(6): 347–352.CrossRefGoogle ScholarPubMed
Deacon, B, Abramowitz, J. Anxiety sensitivity and its dimensions across the anxiety disorders. J Anxiety Disord. 2006; 20(7): 837–857.CrossRefGoogle ScholarPubMed
Witteman, C, Bolks, L, Hutschemaekers, G. Development of the Illness Perception Questionnaire Mental Health. J Ment Health. 2011; 20(2): 115–125.CrossRefGoogle ScholarPubMed
McKay, D, Sookman, D, Neziroglu, F, et al. Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. Psychiatry Res. 2015; 227(1): 104–113.CrossRefGoogle ScholarPubMed
Mayo-Wilson, E, Dias, S, Mavranezouli, I, et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2014; 1(5): 368–376.CrossRefGoogle ScholarPubMed
Escocard, MRPG, Fioravanti-Bastos, ACM, Landeira-Fernandez, J. Anxiety sensitivity factor structure among Brazilian patients with anxiety disorders. J Psychopathol Behav Assess. 2009; 31(3): 246–255.CrossRefGoogle Scholar
Taylor, S, Cox, BJ. Anxiety sensitivity: multiple dimensions and hierarchic structure. Behav Res Ther. 1998; 36(1): 37–51.CrossRefGoogle ScholarPubMed
Whittle, P. Psychiatric disorder and the development of a Causal Belief Questionnaire. J Ment Health. 1996; 5(3): 257–266.CrossRefGoogle Scholar
Keselman, HJ, Games, PA, Rogan, JC. Protecting the overall rate of Type I errors for pairwise comparisons with an omnibus test statistic. Psychol Bull. 1979; 86(4): 884–888.CrossRefGoogle Scholar
Stein, MB. An epidemiologic perspective on social anxiety disorder. J Clin Psychiatry. 2006; 67(suppl 12): 3–8.Google ScholarPubMed
McWilliams, LA, Stewart, SH, MacPherson, PS. Does the social concerns component of the Anxiety Sensitivity Index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity? Behav Res Ther. 2000; 38(10): 985–992.CrossRefGoogle ScholarPubMed
Perez-Edgar, KE, Guyer, AE. Behavioral inhibition: temperament or prodrome? Curr Behav Neurosci Rep. 2014; 1(3): 182–190.CrossRefGoogle ScholarPubMed
Battaglia, M, Ogliari, A, D’Amato, F, Kinkead, R. Early-life risk factors for panic and separation anxiety disorder: insights and outstanding questions arising from human and animal studies of CO2 sensitivity. Neurosci Biobehav Rev. 2014; 46(pt 3): 455–464.CrossRefGoogle ScholarPubMed
do Rosario-Campos, MC, Leckman, JF, Curi, M, et al. A family study of early-onset obsessive-compulsive disorder. Am J Med Genet B, Neuropsychiatr Genet. 2005; 136B(1): 92–97.CrossRefGoogle ScholarPubMed
Beesdo, K, Bittner, A, Pine, DS, et al. Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Arch Gen Psychiatry. 2007; 64(8): 903–912.CrossRefGoogle ScholarPubMed
Lebowitz, ER, Panza, KE, Su, J, Bloch, MH. Family accommodation in obsessive-compulsive disorder. Expert Rev Neurother. 2012; 12(2): 229–238.CrossRefGoogle ScholarPubMed
Potter, CM, Wong, J, Heimberg, RG, et al. Situational panic attacks in social anxiety disorder. J Affect Disord. 2014; 167: 1–7.CrossRefGoogle ScholarPubMed
Brown, LA, LeBeau, R, Liao, B, et al. A comparison of the nature and correlates of panic attacks in the context of panic disorder and social anxiety disorder. Psychiatry Res. 2016; 235: 69–76.CrossRefGoogle ScholarPubMed
Romanelli, RJ, Wu, FM, Gamba, R, et al. Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive-compulsive disorder: a systematic review and meta-analysis of head-to-head randomized controlled trials. Depress Anxiety. 2014; 31(8): 641–652.CrossRefGoogle ScholarPubMed
Imai, H, Tajika, A, Chen, P, et al. Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults. Cochrane Database Syst Rev. 2016; 10: Cd011170.Google ScholarPubMed