Stein Dan J, Ruscio Ayelet Meron, Altwaijri Yasmin, Chiu Wai Tat, Sampson Nancy A, Aguilar-Gaxiola Sergio, Al-Hamzawi Ali, Alonso Jordi, Chardoul Stephanie, Gureje Oye, Hu Chiyi, Karam Elie G, McGrath John J, Navarro-Mateu Fernando, Scott Kate M, Stagnaro Juan Carlos, Torres Yolanda, Vladescu Cristian, Wciórka Jacek, Xavier Miguel, Kessler Ronald C
SAMRC Unit On Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
BMC Med. 2025 Jul 9;23(1):416. doi: 10.1186/s12916-025-04209-5.
National surveys have suggested that obsessive-compulsive disorder (OCD) is a prevalent and impairing condition. However, there are few cross-national data on OCD, with data particularly scarce in low- and middle-income countries. Here we employ data from the World Mental Health surveys to characterize the onset, course, severity, and treatment of OCD across a range of countries in different geographic regions of the world.
Data came from general population surveys carried out in 10 countries (Argentina, Australia, Colombia, Iraq, Poland, People's Republic of China, Portugal, Romania, Saudi Arabia, Spain) using a consistent research protocol and interview. A total of 26,136 adults were assessed for OCD in face-to-face interviews and were included in the present analyses. We examined lifetime and 12-month prevalence as well as age of onset, persistence, severity, and treatment of DSM-IV OCD in six high-income countries (HICs) and four low- or middle-income countries (LMICs). We also investigated socio-demographic variables and temporally prior mental disorders as predictors of OCD onset, persistence, severity, and treatment.
Across the 10 countries surveyed, OCD has a combined lifetime prevalence of 4.1%. The 12-month prevalence (3.0%) is nearly as high, suggesting a highly persistent course of illness. Age of onset is early, with more than 80% of OCD cases beginning by early adulthood. Most OCD cases in the community are mild (47.0%) or very mild (27.5%), with a smaller percentage designated as moderate (22.9%) or severe (2.7%) by the Yale-Brown Obsessive-Compulsive Scale. Only 19.8% of respondents with OCD received any mental health treatment in the past year, with treatment rates much higher in HICs (40.5%) than LMICs (7.0%). Cross-nationally, OCD commonly emerges in adolescence or early adulthood against a backdrop of earlier-occurring mental disorders. With few exceptions (e.g., prior social phobia), the socio-demographic and psychopathological risk factors for OCD onset, persistence, severity, and treatment are distinct.
These cross-national data underscore clinical lessons regarding the importance of early diagnosis of OCD and comprehensive evaluation of comorbidity; draw attention to OCD as an undertreated disorder, particularly in LMIC contexts; and emphasize the public health significance of this often-overlooked condition.
全国性调查表明，强迫症（OCD）是一种普遍存在且会造成损害的病症。然而，关于强迫症的跨国数据很少，在低收入和中等收入国家数据尤其匮乏。在此，我们利用世界心理健康调查的数据来描述强迫症在世界不同地理区域一系列国家中的发病情况、病程、严重程度及治疗情况。
数据来自于在10个国家（阿根廷、澳大利亚、哥伦比亚、伊拉克、波兰、中华人民共和国、葡萄牙、罗马尼亚、沙特阿拉伯、西班牙）开展的一般人群调查，采用一致的研究方案和访谈方式。共有26136名成年人在面对面访谈中接受了强迫症评估，并纳入本分析。我们考察了6个高收入国家（HICs）和4个低收入或中等收入国家（LMICs）中强迫症的终生患病率和12个月患病率，以及发病年龄、病程、严重程度和治疗情况。我们还调查了社会人口统计学变量以及发病时间较早的精神障碍，将其作为强迫症发病、病程、严重程度及治疗的预测因素。
在接受调查的10个国家中，强迫症的终生合并患病率为4.1%。12个月患病率（3.0%）几乎与之相当，表明病程具有高度持续性。发病年龄较早，超过80%的强迫症病例在成年早期发病。社区中大多数强迫症病例为轻度（47.0%）或极轻度（27.5%），根据耶鲁-布朗强迫症量表，被认定为中度（22.9%）或重度（2.7%）的病例占比更小。过去一年中，只有19.8%的强迫症受访者接受过任何心理健康治疗，高收入国家（40.5%）的治疗率远高于低收入和中等收入国家（7.0%）。在跨国层面，强迫症通常在青少年期或成年早期，在更早出现的精神障碍背景下发病。除少数例外情况（如既往社交恐惧症），强迫症发病、病程、严重程度及治疗的社会人口统计学和精神病理学风险因素各不相同。
这些跨国数据强调了有关强迫症早期诊断的重要性和共病综合评估的临床经验；提醒人们注意强迫症是一种治疗不足的疾病，尤其是在低收入和中等收入国家的背景下；并强调了这种常被忽视的疾病的公共卫生意义。
