Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Early Interv Psychiatry. 2021 Dec;15(6):1644-1649. doi: 10.1111/eip.13105. Epub 2020 Dec 29.
Obsessive-compulsive disorder (OCD) is a common and severe disease; however, the duration of untreated illness (DUI) of OCD is approximately 7 years, which is longer than that of other psychiatric disorders. Differences in medical environments have been reported to affect the DUI. Therefore, we surveyed the DUI of OCD in Japan and the reason for delayed treatment.
The study participants were outpatients who visited the OCD specialty outpatient clinic for the first time between June 1, 2017 and May 31, 2019. Obsessive-compulsive disorder was diagnosed using the criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and semistructured clinical interviews, which included asking the reason for the delay in seeking treatment and treatment drop-out history.
Seventy-one patients met the inclusion criteria for the study. The mean period between OCD and the first visit to the hospital was 2.8 years and the mean DUI of OCD was 4.7 years. There was a significant difference in the history of tic disorders and treatment drop out between patients with a DUI of >2 years and those with a DUI of ≤2 years. The most common reason for delaying treatment was that the patient did not consider the symptoms of OCD to be those of an illness, and the most common reason for dropping out of treatment was lack of improvement.
This was the first study on the DUI of OCD in Japan. The DUI was relatively shorter than that found by studies in other countries. Stopping treatment lengthened the duration of the illness. Preventing the patient from dropping out of treatment could further shorten the duration of the illness.
强迫症(OCD)是一种常见且严重的疾病;然而,强迫症的未治疗期(DUI)约为 7 年,长于其他精神障碍。据报道,医疗环境的差异会影响 DUI。因此,我们调查了日本 OCD 的 DUI 及其延迟治疗的原因。
研究对象为 2017 年 6 月 1 日至 2019 年 5 月 31 日期间首次在 OCD 专科门诊就诊的门诊患者。采用《精神障碍诊断与统计手册》第 5 版的标准和半结构式临床访谈对强迫症进行诊断,包括询问寻求治疗延迟的原因和治疗中断史。
71 名患者符合研究纳入标准。强迫症与首次就诊之间的平均时间为 2.8 年,强迫症的平均 DUI 为 4.7 年。 DUI>2 年和 DUI≤2 年的患者在抽动障碍史和治疗中断方面存在显著差异。延迟治疗的最常见原因是患者认为 OCD 的症状不是疾病的症状,治疗中断的最常见原因是没有改善。
这是日本关于 OCD 的 DUI 的第一项研究。 DUI 比其他国家的研究发现的 DUI 相对较短。停止治疗会延长疾病的持续时间。防止患者治疗中断可能会进一步缩短疾病的持续时间。