DURATION OF UNTREATED ILLNESS IN A CROSS-DIAGNOSTIC SAMPLE OF OBSESSIVE-COMPULSIVE DISORDER, PANIC DISORDER, AND SOCIAL ANXIETY DISORDER

• Published in: European neuropsychopharmacology Vol. 28; no. 6; p. 778
• Main Authors: Fontenelle, Leonardo F., Dias, Rafaela V., Laurito, Luana D., Loureiro, Carla P., Vigne, Paula, Stangier, Ulrich, de Menezes, Gabriela B.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-06-2018
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2017.10.026

The factors that facilitate or delay treatment seeking by anxiety and obsessive-compulsive disorder (OCD) patients remain relatively understudied. Besides disorder-specific characteristics, such as severity of different OCD symptoms, there are a few additional cross-diagnostic features that may shorten (e.g. Anxiety Sensitivity) or retard (e.g. Illness Perception) treatment seeking in anxiety and OCD (AOCD) patients, but have not been explored. In this study, we compared duration of untreated illness (DUI) in OCD, Panic Disorder (PD) and Social Anxiety Disorder (SAD) patients and investigated its correlates, both within specific diagnosis and across the whole sample.
Eighty eight patients attending an anxiety disorders clinic (33 OCD, 24 SAD and 31 PD) had their diagnosis confirmed by the Mini International Neuropsychiatric Interview (MINI), were assessed for treatment seeking variables, and were evaluated with a series of instruments aimed at quantifying trans diagnostic features (i.e. The “Cause” Scale of the Illness Perception Questionnaire-Mental Health and the Anxiety Sensitivity Index-Revised) and severity of illness, including the Beck Depression and Anxiety Inventories, the Dimensional Obsessive-Compulsive Scale, the Panic and Agoraphobia Scale, and the Social Phobia Inventory.
The only differences between groups with short (< 2years) vs. long (>2 years) DUI were greater fear of public display of anxiety in the former (Z=-2.15; p=0.03) and greater social avoidance in the later group (t=2.11; df=68.2; p=0.03). The DUI was significantly different between groups who sought treatment after the onset of illness (chi-square=20.5; df=2; p<0.001), with OCD having longer DUI than PD (chi-square=8.99; df=1; p=0.003) and shorter DUI than SAD (chi-square=4.12; df=1; p=0.04). Further, DUI correlated negatively with the perception of OCD being caused by stress (rho=-0.39; p=0.03), and positively with severity of panic-related disability (rho=0.51; p=0.01) in SAD, but not in PD or OCD patients.
There was usually a substantial delay in treatment seeking among AOCD patients, particularly in subjects with OCD or SAD. Perception of stress as a cause of OCD prompted treatment seeking, while severity of panic symptoms delayed treatment seeking in SAD patients.