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OCD in Women: Diagnosis and Magnitude

Published online by Cambridge University Press:  07 November 2014

Teresa A. Pigott
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Extract

Key Diagnostic 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.

Type
Symposium Monograph Supplement
Information
CNS Spectrums , Volume 9 , Issue 9 , September 2004 , pp. 14 - 16
Copyright
Copyright © Cambridge University Press 2004

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References

1. Diagnostic and Statistical Manual of PAental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2. Antony, MM, Downie, F, Swinson, RP. Diagnostic issues and epidemiology in OCD. In: Swinson, RP, Antony, MM, Rachman, S, Richter, MA, eds. OCD: Theory, Research, and Treatment. New York, NY: Guilford Press; 1998:3–32.Google Scholar
3. Rasmussen, SA, Eisen, JL. The epidemiology and differential diagnosis of obsessive-compulsive disorder. J Clin Psychiatry. 1994;55(Suppl):5–10.Google ScholarPubMed
4. Mataix-Cols, D, Rauch, SL, Manzo, PA, Jenike, MA, Baer, L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156(9):1409–1416.Google Scholar
5. Summerfeldt, LJ, Richter, MA, Antony, MM, Swinson, RP. Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study. Behav Res Ther. 1999;37(4):297–311.CrossRefGoogle ScholarPubMed
6. Mataix-Cols, D, Rauch, SL, Baer, L, et al. Symptom stability in adult obsessive-com-pulsive disorder: data from a naturalistic two-year follow-up study. Am J Psychiatry. 2002;159(2):263–268.CrossRefGoogle ScholarPubMed
7. Karno, M, Golding, JM, Sorenson, SB, Burnam, MA. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45(12):1094–1099.CrossRefGoogle ScholarPubMed
8. Weissman, MM, Bland, RC, Canino, GJ, et al. The cross-national epidemiology of obsessive-compulsive disorder. The Cross National Collaborative Group. J Clin Psychiatry. 1994;55(Suppl):5–10.Google Scholar
9. Rasmussen, S, Eisen, J. Epidemiology of obsessive-compulsive disorder. J Clin Psychiatry. 1990;51:10–13.Google Scholar
10. Lochner, C, Hemmings, SM, Kinnear, CJ, et al. Gender in obsessive-compulsive disorder: clinical and genetic findings. Eur Neuropsychopharmacol. 2004;14(2): 105–113.Google Scholar
11. Geller, DA, Biederman, J, Jones, J, Shapiro, S, Schwartz, S, Park, KS. Obsessive-compulsive disorder in children and adolescents: a review. Harv Rev Psychiatry. 1998;5(5):260–273.CrossRefGoogle ScholarPubMed
12. Hanna, GL. Demographic and clinical features of obsessive-compulsive disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1995;34(1):19–27.Google Scholar
13. Fontenelle, LF, Mendlowicz, MV, Marques, C, Versiani, M. Early- and late-onset obsessive-compulsive disorder in adult patients: an exploratory clinical and therapeutic study. J Psychiatr Res. 2003;37(2):127–133.Google Scholar
14. Bogetto, F, Venturello, S, Albert, U, Maina, G, Ravizza, L. Gender-related clinical differences in obsessive-compulsive disorder. Eur Psychiatry. 1999;14(8):434–441.Google Scholar
15. Hollander, E, Kwon, JH, Stein, DJ, et al. Psychosocial function and economic costs of obsessive-compulsive disorder. CNS Spectr. 1998;3(5):48–58.Google Scholar
16. Dupont, R, Rice, D, Shiraki, S, Rowland, C. Pharmacoeconomics: economic costs of obsessive-compulsive disorder. Med Interface. 1995;4:102–109.Google Scholar
17. Noshirvani, HF, Kasvikis, Y, Marks, IM, Tsakiris, F, Monteiro, WO. Gender-divergent aetiological factors in obsessive-compulsive disorder, Br J Psychiatry. 1991;158:260–263.Google Scholar
18. Maina, G, Albert, U, Bogetto, F, Vaschetto, P, Ravizza, L. Recent life events and obsessive-compulsive disorder (OCD): the role of pregnancy/delivery. Psychiatry Res. 1999;89(1):49–58.Google Scholar
19. Lensi, P, Cassano, GB, Correddu, G, Ravagli, S, Kunovac, JL, Akiskal, HS. Obsessive-compulsive disorder. Familial developmental history, symptomatology, comorbidity and course with special reference to gender-related differences. Br J Psychiatry. 1996;169(1):101–107.Google Scholar
20. Pigott, TA. Anxiety disorders in women. Psychiatr Clin N Am. 2003;26:621–672.Google Scholar
21. Valleni-Basile, LA, Garrison, CZ, Jackson, KL, et al. Frequency of OCD in community sample of young adolescents. J Am Acad Chiid Adol Psychiatry. 1994;33(6):782–791.CrossRefGoogle ScholarPubMed
22. Steketee, G, Eisen, J, Dyck, I, Warshaw, M, Rasmussen, S. Predictors of course in obsessive-compulsive disorder. Psychiatry Res. 1999;89(3):229–238.Google Scholar
23. Eisen, JL, Goodman, WK, Keller, MB, et al. Patterns of remission and relapse in obsessive-compulsive disorder: a 2-year prospective study. J Clin Psychiatry. 1999;60(5):346–351.CrossRefGoogle ScholarPubMed
24. Dillon, K, Brooks, D. Unusual cleaning behavior in the luteal phase. Psychol Rep. 1992;70(1):35–39.CrossRefGoogle ScholarPubMed
25. Williams, K, Koran, L. Obsessive-compulsive disorder in pregnancy, the puerperium, and the premenstruum. J Clin Psychiatry. 1997;58(7):330–334.Google Scholar
26. Neziroglu, F, Anemone, R, Yaryura-Tobias, J. Onset of obsessive-compulsive disorder in pregnancy. Am J Psychiatry. 1992;149(7):947–950.Google Scholar
27. Brandes, M, Soares, CN, Cohen, LS. Postpartum onset obsessive-compulsive disorder: diagnosis and management. Arch Women Ment Health. 2004;7(2):99–110.Google Scholar
28. Geller, P, Klier, C, Neugebauer, R. Anxiety disorders following miscarriage. J Clin Psychiatry. 2001;62(6):432–438.Google Scholar
29. Goodman, W. Obsessive-compulsive disorder: diagnosis and treatment. J Clin Psychiatry. 1999;60(18):27–32.Google Scholar
30. Overbeek, T, Schruers, K, Vermetten, E, Greiez, E. Comorbidity of OCD and depression prevalence, symptom severity, and treatment effect. J Clin Psychiatry. 2002;63(12):1106–1112.Google Scholar
31. Pigott, TA, LHeureux, F, Dubbert, B, Bernstein, S, Murphy, DL. Obsessive-compulsive disorder: comorbid conditions. J Clin Psychiatry. 1994;55(Suppl):15–27.Google Scholar
32. Gershuny, BS, Baer, L, Jenike, MA, Minichiello, WE, Wilhelm, S. Comorbid PTSD: impact on treatment outcome for OCD. Am J Psychiatry. 2002;159(5):852–854.Google Scholar
33. Carrasco, JL, Hollander, E, Schneier, FR, Liebowitz, MR. Treatment outcome of obsessive compulsive disorder with comorbid social phobia. J Clin Psychiatry. 1992;53(11):387–391.Google Scholar
34. Fahy, T, Osacar, A, Marks, IM. History of eating disorders in female patients with, OCD. Int J Eat Disord. 1993;14(4);439–443.Google Scholar
35. Rubenstein, CS, Pigott, TA, L'Heureux, F, Hill, JL, Murphy, DL. A preliminary investigation of the lifetime prevalence of anorexia and bulimia nervosa in patients with obsessive-compulsive disorder. J Clin Psychiatry. 1992;53(9):30–314.Google Scholar
36. Tamburrino, MB, Kaufman, R, Hertzer, J. Eating disorder history in women with obsessive-compulsive disorder. J Am Med Womens Assoc. 1994;49(1):24–26.Google Scholar
37. Grabe, HJ, Thiel, A, Freyberger, HJ. Symptoms of eating disorders in obsessivecom-pulsive disorder. Acta Psychiatr Scand. 2000;102(6):449–453.Google Scholar
38. Pigott, TA, Altemus, M, Rubenstein, CS, et al. Symptoms of eating disorders in patients with obsessive-compulsive disorder. Am J Psychiatry. 1991;148(11):1552–1557.Google Scholar
39. Zubieta, JK, Demitrack, MA, Fenick, A, Krahn, DD. Obsessionality in eating-disorder patients: relationship to clinical presentation and two-year outcome. J Psychiatr Res. 1995;29(4):333–342.Google Scholar
40. Thiel, A, Zuger, M, Jacoby, GE, Schussler, G. Thirty-month outcome in patients with anorexia or bulimia nervosa and concomitant obsessive-compulsive disorder. Am J Psychiatry. 1998;155(2):244–249.CrossRefGoogle ScholarPubMed
41. von Ranson, KM, Kaye, WH, Wekzin, TE, Rao, R, Matsunaga, H. Obsessivecom-pulsive disorder symptoms before and after recovery from bulimia nervosa. Am J Psychiatry. 1999;156(11):1703–1708.CrossRefGoogle ScholarPubMed
42. du Toit, PL, van Kradenburg, J, Niehaus, D, Stein, DJ. Comparison of obsessive-compulsive disorder patients with and without comorbid putative obsessivecom-pulsive spectrum disorders using a structured clinical interview. Compr Psychiatry. 2001;42(4):291–300.CrossRefGoogle ScholarPubMed