Obsessive-compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population

Obsessive-compulsive disorder (OCD) is a particularly debilitating disorder characterized by early onset, chronic course, and significant comorbidity. People with OCD often delay or are unwilling to seek treatment. The aim of the study was to establish the prevalence and correlates of obsessive compulsive disorder in the Singapore population, to determine types of obsessive compulsive (O/C) symptoms, the comorbidity of the disorder and to examine the quality of life among those with OCD. The Singapore Mental Health Study was a cross-sectional epidemiological survey of the adult, resident Singapore population. Face-to-face interviews were completed with 6,616 respondents between December 2009 and December 2010 giving a survey response rate of 75.9 %. The diagnoses of lifetime and 12-month mental disorders were established using Version 3.0 of the Composite International Diagnostic Interview (CIDI-3.0); clinical severity of cases in past 12-months was assessed using a fully structured version of the Yale-Brown Obsessive-Compulsive Scale and functional impairment was assessed by using the disease specific Sheehan Disability Scale, which are incorporated in the CIDI. Health-related quality of life was measured using the Euro-Quality of Life Scale. The lifetime and 12-month prevalence of OCD was 3.0 and 1.1 %, respectively. Younger age and marital status (divorced or separated) were significantly associated with OCD. About 40 % of respondents with lifetime OCD met criteria for other lifetime mental disorders, while 51.6 % of respondents with lifetime OCD had a comorbid physical disorder. The mean score of EQ-Index (0.89) and EQ-VAS (75.58) were lowest in OCD cases as compared with those with any other mental or physical disorders. The proportion of those with lifetime OCD who had sought treatment was 10.2 %. While OCD is not an extremely prevalent disorder, it has a profound impact on quality of life and daily activities of those suffering from the disorder. The large treatment gap among those with OCD and the significant delay in seeking treatment after the onset of the illness makes OCD a disorder of significant public health priority.