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The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication
Open accessAbstract
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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“Obsessive–compulsive disorder (OCD) is a mental health condition with a lifetime prevalence of 2–3% that causes significant impact on the quality of life of sufferers (Koran, Thienemann, & Davenport, 1996; Ruscio, Stein, Chiu, & Kessler, 2010).”
From Obsessive–compulsive disorder (OCD) is associated with increased engagement of frontal brain regions across multiple event-related potentials (2023) · cites this paper as Ruscio, Stein, Chiu, & Kessler, 2010
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“Obsessive-compulsive disorder (OCD) is a debilitating mental health condition, with a frequently chronic course and impairing effect on sufferers of the condition [8] and their family members alike [9].”
From Testing the psychometric properties of the illness perceptions questionnaire for OCD (IPQ-O) (2019) · cites this paper as [8]
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“Il prédit également une comorbidité significative du fait de la non-spécificité cognitive des processus impliqués, comorbidité avérée pour le TOC (Adam, Meinlschmidt, Gloster et Lieb, 2011; Ruscio, Stein, Chiu et Kessler, 2010).”
From Les thérapies de troisième vague dans le traitement du trouble obsessionnel-compulsif: Application de la thérapie d’acceptation et d’engagement (2014) · cites this paper as Ruscio, Stein, Chiu et Kessler, 2010
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“In humans, OCD symptoms typically appear relatively early in life with a mean onset at 19.5 years of age [31].”
From Projection-specific deficits in synaptic transmission in adult Sapap3-knockout mice (2020) · cites this paper as [31]
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Metadata
- 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
- PMC
- PMC2797569
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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