Obsessive-compulsive disorder: a concealed diagnosis.

Epidemiologic data suggest that obsessive-compulsive disorder is the fourth most common mental disorder, after phobias, substance abuse and depression, and is nearly as common as asthma and diabetes mellitus. The understanding of obsessive-compulsive disorder and its treatment have significantly improved over the past decade. Positron emission tomographic scanning has demonstrated characteristic changes in the cerebral metabolism of patients with obsessive-compulsive disorder. Selective serotonin reuptake inhibitors have been shown to alleviate the symptoms of this disorder. Treatment of obsessive-compulsive disorder includes drug therapy, behavior therapy and family therapy. The family physician can play a key role in recognizing the clinical markers of obsessive-compulsive disorder and negotiating a treatment plan that significantly lessens the psychosocial morbidity associated with it.