Many common presentations of obsessive-compulsive disorder unrecognized by medical providers in a Pacific Island community

Abstract

Purpose Obsessive-compulsive disorder (OCD) is a serious mental health condition that is frequently misdiagnosed and left untreated for extended periods. A contributing factor may be the lack of awareness regarding OCD’s heterogeneous symptom presentations in nonpsychiatric medical providers (MPs). Nonpsychiatric MPs are often consulted by those with OCD and are thus in a key position to first identify the symptoms in a person. Thus, the purpose of this study is to assess nonpsychiatric MPs’ ability to recognize varying symptom presentations of OCD. Design/methodology/approach The current study examined OCD recognition rates in 105 nonpsychiatric MPs practicing on Guam – a rural island community with limited mental health resources. Participants were randomly assigned to read one of six vignettes describing a common obsessional theme within OCD (i.e. contamination, symmetry, religion, homosexuality, pedophilia or aggression) and asked to provide their diagnostic impressions. Findings Over half of participating MPs (58.1%) did not recognize the condition in the vignettes as OCD. As groups, vignettes describing taboo obsessions were significantly less likely to be recognized as OCD than those describing contamination and symmetry obsessions. Overall, results reveal that MPs are largely unaware of the diversity of OCD symptoms. Originality/value Few studies have examined nonpsychiatric MPs’ awareness of varying OCD symptom presentations, and to the best of the authors’ knowledge, no studies to date have been conducted on MPs practicing in rural settings. The findings of this study can inform training programs for MPs to help decrease OCD misdiagnoses in medical settings.