ABSTRACT
BACKGROUND: Obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD) and other OCD-related disorders (OCDs) are frequently overlooked during medical or even psychiatric evaluation. Individuals with affective disorders, anxiety disorders, eating disorders, alcohol abuse and schizophrenia are commonly affected. Increased prevalence of OCDs is also reported to occur in certain secondary health-care settings. Better identification and treatment of OCDs are increasingly recognized as important public health priorities. METHOD: In this narrative review we consider the arguments for the use of screening strategies for OCD in clinical practice, paying particular attention to pragmatic issues such as the shortage of suitable screening instruments and areas of medical practice where screening might most profitably be exercised. RESULTS: Arguments for screening in fields where affected individuals congregate appear persuasive, although evidence that screening produces clinical and social benefits by reducing morbidity is still lacking. CONCLUSION: Confirmation of health-care settings attracting high concentrations of OCD and BDD and evaluation of specific screening instruments and their utility in reducing the burden of disease are important areas for future research. Further evaluation of the validity and reliability of specific screening tools across different clinical populations is required.
Subject(s)
Mass Screening , Obsessive-Compulsive Disorder/diagnosis , Adolescent , Adult , Anxiety Disorders/diagnosis , Child , Comorbidity , Compulsive Behavior/diagnosis , Diagnosis, Differential , Humans , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Personality Assessment , Practice Guidelines as Topic , Program Development , Psychiatric Status Rating Scales , Somatoform Disorders/diagnosis , United Kingdom/epidemiologyABSTRACT
BACKGROUND: This study was prompted by reports suggesting a high prevalence of unrecognized obsessive-compulsive disorder (OCD) in the dermatology clinic. METHOD: 92 consecutive dermatology referrals were screened for DSM-IV OCD using the Mini-International Neuropsychiatric Inverview (MINI), the Yale-Brown Obsessive Compulsive Scale (YBOCS), and the 5-item screening questionnaire from the International Council on OCD. Illness severity was rated on the YBOCS, and symptom profiles and dermatologic diagnoses were established for screen-positive cases. RESULTS: 18 patients (20%) qualified for a DSM-IV diagnosis of OCD, of whom 17 were previously undiagnosed. The range and type of OCD symptoms covered the normal clinical spectrum. Most patients had more than 1 symptom, and among obsessions (including somatic obsessions), checking, washing, and symmetry were common. The mean total YBOCS score was 16/40 (SD = 7.2), indicating moderate OCD, and 40% of the positive cases scored 16 or higher. Dermatologic diagnoses were various and did not seem to bear a direct relationship with the OCD. CONCLUSION: These results suggest that there is a high prevalence of clinically relevant OCD in the dermatology clinic. This is an area that merits attention with regard to better recognition and treatment for OCD sufferers.
