Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Frankfurt, Frankfurt, Germany.
CNS Spectr. 2019 Oct;24(5):526-532. doi: 10.1017/S1092852918001281.
In this study, we compared duration of untreated illness (DUI) in obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD) patients and investigated its correlates, both within specific diagnoses and across the whole sample.
Eighty-eight patients (33 OCD, 24 SAD, and 31 PD) had their diagnosis confirmed by the Mini International Neuropsychiatric Interview, were assessed for treatment-seeking variables, and were evaluated with instruments aimed at quantifying transdiagnostic features (i.e., the Cause subscale of the Illness Perception Questionnaire-Mental Health and the Anxiety Sensitivity Index-Revised) and severity of illness (i.e., Beck Depression and Anxiety Inventories, the Dimensional Obsessive-Compulsive Scale, the Panic and Agoraphobia Scale, and the Social Phobia Inventory).
The only differences between groups with short (<2 years) versus long (>2 years) DUI were greater fear of public display of anxiety in the first group and greater social avoidance in the second group. The DUI was significantly different between groups that sought treatment after the onset of illness, with OCD patients having longer DUI than PD patients and shorter DUI than SAD patients. Further, DUI correlated negatively with the perception of OCD being caused by stress and positively with severity of panic-related disability in SAD patients, but not in PD or OCD patients.
There was substantial delay in treatment seeking among the anxiety and obsessive-compulsive disorder patients, particularly those with OCD or SAD. Perception of stress as a cause of OCD prompted treatment seeking, while severity of panic symptoms delayed treatment seeking.
本研究比较了强迫症(OCD)、惊恐障碍(PD)和社交焦虑障碍(SAD)患者的未治疗疾病期(DUI)持续时间,并在特定诊断内和整个样本中研究了其相关性。
88 名患者(33 名 OCD、24 名 SAD 和 31 名 PD)通过迷你国际神经精神访谈确认诊断,评估其寻求治疗的变量,并使用旨在量化跨诊断特征(即疾病感知问卷-心理健康的原因子量表和焦虑敏感性指数-修订版)和疾病严重程度的工具进行评估(即贝克抑郁和焦虑量表、多维强迫量表、惊恐和广场恐怖症量表以及社交恐惧症量表)。
只有两组 DUI(<2 年和>2 年)之间存在差异,即第一组对焦虑在公众场合表现的恐惧更大,第二组社会回避更多。与发病后开始治疗的组相比,DUI 在组间有显著差异,OCD 患者的 DUI 长于 PD 患者,短于 SAD 患者。此外,DUI 与 SAD 患者对 OCD 由压力引起的感知呈负相关,与 SAD 患者与惊恐相关的残疾严重程度呈正相关,但与 PD 或 OCD 患者无关。
焦虑和强迫症患者,特别是 OCD 或 SAD 患者,寻求治疗的时间存在明显延迟。将压力视为 OCD 的原因会促使寻求治疗,而惊恐症状的严重程度会延迟治疗的寻求。