Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil; Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (CTOC), Brazil.
Department of Statistics, The University of Western Australia, Perth, Australia.
Psychiatry Res. 2022 Jun;312:114567. doi: 10.1016/j.psychres.2022.114567. Epub 2022 Apr 19.
This study aimed to identify the factors associated with a delay in treatment-seeking among patients with obsessive-compulsive disorder (OCD), a disabling neuropsychiatric disorder. To achieve this purpose, we conducted a cross-sectional study examining latency to treatment (LTT) and its associated correlates in 863 patients with OCD. We defined LTT as the time lag between the awareness of discomfort and/or impairment caused by symptoms and the beginning of OCD-specific treatment. To determine the socio-demographic and clinical characteristics associated with LTT, we built an interval-censored survival model to simultaneously assess the relationship between all variables, representing the best fit to our data format. The results of our study showed that approximately one-third of OCD patients sought treatment within two years of symptom awareness, one-third between two and nine years, and one-third after ten or more years. Median LTT was 4.0 years (mean = 7.96, SD = 9.54). Longer LTT was associated with older age, early onset of OCD symptoms, presence of contamination/cleaning symptoms and full-time employment. Shorter LTT was associated with the presence of aggression symptoms and comorbidity with hypochondriasis. The results of our study confirm the understanding that LTT in OCD is influenced by several interdependent variables - some of which are modifiable. Strategies for reducing LTT should focus on older patients, who work in a full-time job, and on individuals with early onset of OCD and contamination/cleaning symptoms.
本研究旨在确定与强迫症（OCD）患者治疗延迟相关的因素，OCD 是一种使人衰弱的神经精神障碍。为了达到这个目的，我们进行了一项横断面研究，检查了 863 名强迫症患者的治疗延迟（LTT）及其相关因素。我们将 LTT 定义为从症状引起的不适和/或功能障碍意识到开始接受 OCD 特异性治疗之间的时间滞后。为了确定与 LTT 相关的社会人口学和临床特征，我们建立了一个区间 censored 生存模型，以同时评估所有变量之间的关系，这是最适合我们数据格式的方法。研究结果表明，大约三分之一的 OCD 患者在症状出现后两年内寻求治疗，三分之一在两年至九年之间，三分之一在十年或更长时间后寻求治疗。中位数 LTT 为 4.0 年（平均值=7.96，标准差=9.54）。较长的 LTT 与年龄较大、OCD 症状早发、存在污染/清洁症状和全职工作有关。较短的 LTT 与攻击症状的存在和与疑病症的共病有关。我们的研究结果证实了这样一种理解，即 OCD 中的 LTT 受到几个相互依存的变量的影响，其中一些是可以改变的。减少 LTT 的策略应侧重于年龄较大、全职工作的患者，以及 OCD 症状早发和存在污染/清洁症状的个体。
