Cited by 2,771Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication

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Ruscio, A M, Stein, D J, Chiu, W T, Kessler, R C·2010·Molecular Psychiatry

Abstract

Despite significant advances in the study of obsessive-compulsive disorder (OCD), important questions remain about the disorder's public health significance, appropriate diagnostic classification, and clinical heterogeneity. These issues were explored using data from the National Comorbidity Survey Replication, a nationally representative survey of US adults. A subsample of 2073 respondents was assessed for lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) OCD. More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives. While conditional probability of OCD was strongly associated with the number of obsessions and compulsions reported, only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD. OCD is associated with substantial comorbidity, not only with anxiety and mood disorders but also with impulse-control and substance use disorders. Severity of OCD, assessed by an adapted version of the Yale-Brown Obsessive Compulsive Scale, is associated with poor insight, high comorbidity, high role impairment, and high probability of seeking treatment. The high prevalence of subthreshold OCD symptoms may help explain past inconsistencies in prevalence estimates across surveys and suggests that the public health burden of OCD may be greater than its low prevalence implies. Evidence of a preponderance of early onset cases in men, high comorbidity with a wide range of disorders, and reliable associations between disorder severity and key outcomes may have implications for how OCD is classified in DSM-V.

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Authors
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C.
Affiliations
  • University of Pennsylvania (US)
  • University of Cape Town (ZA)
  • Harvard University (US)
Corresponding author
Kessler, R C
Venue
Molecular Psychiatry
Published
2008-08-26
Volume
15
Issue
1
Pages
53-63
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
OpenAlex
W2100861230
Cited by
2,771
References
68
Citations by year
2026: 172 · 2025: 255 · 2024: 191 · 2023: 205 · 2022: 247 · 2021: 238 · 2020: 288 · 2019: 177 · 2018: 176 · 2017: 143 · 2016: 128 · 2015: 150 · 2014: 101 · 2013: 88 · 2012: 102
FWCI
38.53
Type
journal article
Language
en
Open access
Locations
  • Molecular Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01-MH-60220, K01MH076162, U13MH066849, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (R03TW006481)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
obsessive-compulsive disorder, prevalence, comorbidities, subthreshold symptoms, obsessions and compulsions, disorder severity, Yale-Brown Obsessive Compulsive Scale, insight, role impairment, treatment seeking, public health burden, anxiety disorders, mood disorders, impulse control disorders, substance use disorders, National Comorbidity Survey Replication
MeSH terms
Adolescent, Adult, Female, Follow-Up Studies, Health Surveys, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Retrospective Studies, Severity of Illness Index, Socioeconomic Factors, Comorbidity, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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