Hostname: page-component-5b777bbd6c-2hk6m Total loading time: 0 Render date: 2025-06-23T22:04:04.372Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial Function and Economic Costs of Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  07 November 2014

Eric Hollander ,
Dan J. Stein ,
Jee H. Kwon ,
Clayton Rowland ,
Cheryl M. Wong ,
James Broatch  and
Carol Himelein
Get access Rights & Permissions [Opens in a new window]

Abstract

The study presented was conducted to analyze the effects of obsessive-compulsive symptoms on patients' quality of life and the costs incurred by patients and society for the treatment of obsessive-compulsive disorder (OCD). To accomplish this, a detailed 410-item questionnaire of psychosocial function and economic cost was sent to every fourth member of the Obsessive Compulsive Foundation. Of the 2,670 members who received the survey, 701 (26.9%) returned it.

Outcome measures included symptomatology, course of illness, impact of illness on psychosocial and other functioning, effects of diagnosis and treatment, and economic consequences. The demographics of this group were similar to those in smaller treatment-seeking clinical samples, but not necessarily to OCD sufferers within the US population as a whole. More than half of the patients reported moderate to severe interference in family relationships, socializing, and ability to study or work, secondary to OCD symptoms. A 10.2-year gap was observed between the onset of symptoms and the first attempt to seek professional help, and a 17.2-year gap was observed between the onset of symptoms and receipt of effective treatment. Specific treatments, such as serotonin reuptake inhibitors and behavior therapy showed greater symptom improvement, and significantly reduced the total annual fees incurred by OCD patients when compared with nonspecific treatments.

Our study results indicate that OCD has a profound effect on psychosocial functioning and quality of life. Large direct costs for OCD, and even larger indirect costs due to lost wages and underemployment were found. Greater awareness of OCD among practitioners may result in earlier diagnosis and more appropriate and cost-effective treatments.

Type
Feature Articles
Information
CNS Spectrums , Volume 2 , Issue 10: New Research: Functional Imaging, Phylogenetic Models, and Pharmacoeconomics , December 1997 , pp. 16 - 25
Copyright
Copyright © Cambridge University Press 1997

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.)

Article purchase

Temporarily unavailable

References

1.Karno, M, Golding, JM, Sorenson, SB, Burnam, A. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45:1094–1099.Google Scholar
2.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
3.Leonard, HL, Swedo, SE, Lenane, MC, et al.A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatry. 1993;50:429–439.Google Scholar
4.A Gallup Study of Obsessive-Compulsive Disorder Sufferers. Princeton, NJ: Gallup Organization; 1990.Google Scholar
5.Koran, LM, Thieneman, ML, Davenport, R. Quality of life for patients with obsessive-compulsive disorder. Am J Psychiatry. 1996;153:783–788.Google Scholar
6.DuPont, RL, Rice, DP, Shiraki, S, Rowland, CR. Pharmacoeconomics: economic costs of obsessive-compulsive disorder. Medical Interface. April 1995:102–109.Google Scholar
7.Martin, P. Medical economic impact of schizophrenia. Encephale. 1995;21(Spec No 3):67–73.Google Scholar
8.Greenberg, PE, Stiglin, LE, Finkelstein, SN. The economic burden of depression in 1990. J Clin Psychiatry. 1993;54:405–413.Google ScholarPubMed
9.Steketee, G, Grayson, JB, Foa, EB. A comparison of characteristics of obsessive-compulsive disorder and other anxiety disorders. Journal of Anxiety Disorders. 1987;1:325–335.Google Scholar
10.Swedo, SE, Rapoport, JL, Leonard, H, Lenane, M, Cheslow, D. Obsessive-compulsive disorder in children and adolescents. Arch Gen Psychiatry. 1989;46:335–341.Google Scholar
11.Riddle, MA, Scahill, L, King, R, et al.Obsessive compulsive disorder in children and adolescents: phenomenology and family history. J Am Acad Child Adolesc Psychiatry. 1990;29:766–772.CrossRefGoogle ScholarPubMed
12.Rasmussen, SA, Eisen, JL. The epidemiology and differential diagnosis of obsessive-compulsive disorder. J Clin Psychiatry. 1994;55(suppl):5–10.Google ScholarPubMed
13.Shahady, EJ. Obsessive-compulsive disorder in primary care. J Clin Psychiatry. 1994;55(suppl):79–82.Google Scholar
14.The Clomipramine Collaborative Study Group. Clomipramine in the treatment of patients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1991;48:730–738.CrossRefGoogle Scholar
15.Tollefson, GD, Rampey, AH, Potvin, JH, et al.A multicenter investigation of fixed dose fluoxetine in the treatment of obsessive-compulsive disorder. Arch Gen Psychiatry. 1994;51:559–567.Google Scholar
16.Freeman, CPL, Trimble, MR, Deakin, JFW, Stokes, TM, Ashford, JJ. Fluvoxamine versus clomipramine in the treatment of obsessive-compulsive disorder: a multicenter, randomized, double-blind, parallel group comparison. J Clin Psychiatry. 1994;55:301–305.Google Scholar
17.Greist, J, Chouinard, G, DuBoff, E, Halaris, A. Double-blind parallel comparison of three dosages of sertraline and placebo in outpatients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1995;52:289–295.CrossRefGoogle ScholarPubMed
18.Baer, L, Minichiello, WE. Behavior therapy for obsessive-compulsive disorder. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Theory and Management. Chicago, Ill: Year Book Medical Publishers; 1990:203–232.Google Scholar
19.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale, I: development, use, and reliability. Arch Gen Psychiatry. 1989:46:1006–1011.Google Scholar
20.U.S. Bureau of the Census. Statistical Abstract of the United States: 1995. 115th ed. Washington, DC: 1995.Google Scholar
21.Rasmussen, SA, Eisen, JL. Epidemiology of obsessive compulsive disorder. J Clin Psychiatry. 1990;51(suppl):10–13.Google Scholar
22.Rasmussen, SA, Eisen, JL. Epidemiology and clinical features of obsessive-compulsive disorder. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Theory and Management. Chicago, Ill: Year Book Medical Publishers; 1990:203–232.Google Scholar
23.Simeon, D, Hollander, E, Stein, DJ, Cohen, L, Aronowitz, B. Body dysmorphic disorder in the DSM-IV field trial for obsessive-compulsive disorder. Am J Psychiatry. 1995;152:1207–1209.Google Scholar
24.Foa, EB, Kozak, MJ, Goodman, WK, Hollander, E, Jenike, MA, Rasmussen, SA. DSM-IV field trial: obsessive-compulsive disorder. Am J Psychiatry. 1995:152:654.Google Scholar
25.Hollander, E, Wong, CM. Developments in the treatment of obsessive-compulsive disorder. Primary Psychiatry. 1995;2:28–33.Google Scholar
26.Hollander, E, Greenwald, S, Neville, D, Johnson, J, Hornig, CD, Weissman, MM. Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiological sample. Depression and Anxiety. 1996/1997:4:111–119.Google Scholar
27.Angst, J. OCD in the Zurich Cohort Study. Second International Obsessive Compulsive Disorder Conference; February 1996; Guadeloupe. Abstract.Google Scholar
28.Van-Oppen, P, de-Haan, E, Van-Balkom, AJLM, Spinhoven, P, Hoogduin, K, Van-Dyck, R. Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder. Behav Res Ther. 1995;33:379–390.Google Scholar