OCD Associated With Socioeconomic Factors and Mental Health Comorbidities

People diagnosed with OCD were associated with a lower socioeconomic status and comorbid conditions affecting their mental health.

The estimated prevalence of lifetime obsessive compulsive disorder (OCD) in the Canadian population is 0.93%, according to a study published in Psychiatry Research. People diagnosed with OCD were associated with a lower socioeconomic status and comorbid conditions affecting their mental health. Additionally, substance or alcohol abuse and negative childhood experiences had links with OCD.  

This cross-sectional study sought to examine the prevalence of OCD in Canada and the association of OCD to related comorbidities, sociodemographic factors, childhood experiences, and utilization of healthcare services. Data was analyzed for a cohort of 25,097 participants aged 15 and older who responded to the population-based Canadian Community Health Survey – Mental Health 2012.

The study examined data specific to lifetime OCD diagnoses, including prevalence of comorbid conditions, substance abuse and dependence, negative childhood experiences, and healthcare utilization. Demographic and socioeconomic factors were considered, including gender, age, education, employment, and income. Participants were screened for presence of specific mood disorders, anxiety, and attention deficit disorders. Utilization of health care was examined by the number of hospitalizations, likelihood of hospitalization, or likelihood of speaking with healthcare professionals.

Of the 25,097 participants, 267 responded positively to having received an OCD diagnosis, indicating that OCD was prevalent in 0.93% (95% CI 0.75 to 1.11) of the Canadian population. Compared to the control population, demographic factors associated with OCD pointed to younger individuals with lower incomes, and a higher proportion of patients with OCD were diagnosed with mood disorders (such as depression and bipolar disorder), ADHD, and general anxiety disorders. An OCD diagnosis was significantly associated with alcohol dependence and substance abuse; negative childhood experiences were more common in people with OCD, in which 72.33% (95% CI 62.25% to 82.41%) suffered some form of childhood maltreatment.

A final result of the survey showed that patients with OCD frequently utilized healthcare services. While the number of hospitalizations per year was similar to the control population, people with OCD were more likely to report needing but not receiving help for emotional and mental health problems or problems with substance abuse. The study investigators suggest that this finding exposes a gap in treatment and resources available to help patients with OCD.

Limitations of the study included relying on subjects to self-report professionally diagnosed OCD. The survey did not include screening questions for OCD and therefore did not account for people with undiagnosed OCD. Institutionalized individuals were also left out of the survey, which may have contributed to an underestimation of the prevalence of OCD.

Overall, a lower socioeconomic status, childhood maltreatment, and the presence of comorbid mental health conditions were associated with diagnosed OCD in the studied Canadian population. Although the OCD cohort felt like they received inadequate support for their problems, they were more likely to utilize different healthcare services, indicating that improved access to clinical resources could benefit patients with OCD.   

Reference

Osland S, Arnold PD, Pringsheim T. The prevalence of diagnosed obsessive compulsive disorder and associated comorbidities: a population-based Canadian studyPsychiatry Res. 2018;268:137-142.

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