Debunking Myths: The Complex Demographics of Obsessive-Compulsive Disorder (OCD)
Greetings! In February, I'll be sharing a series of short blogs, each aimed at dispelling common myths and misconceptions about Obsessive-Compulsive Disorder (OCD). The goal is simple: to provide straightforward information that clarifies misunderstandings and promotes a more accurate understanding of OCD. Join me weekly as we explore different aspects of the disorder and work towards fostering a more informed and open conversation about mental health.
As a recap from previous information provided, Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that individuals feel driven to perform. OCD is often surrounded by a variety of misconceptions. One of these misconceptions can be regarding the demographics of those affected. The goal of this week’s blog series is to take a brief look at the complexities of OCD demographics. We will challenge assumptions and shed light on the diversity of individuals who experience this OCD.
Gender Distribution: Breaking Stereotypes
Did you ever think individuals of a specific identifying gender were affected more than others? Turns out, research suggests that it may depend on the age of the individual, too. Some studies report individuals who identify as females have a higher prevalence of OCD ("National Institute of Mental Health," n.d.). But, others indicate, as adults, there is a pretty balanced distribution (Ruscio et al., 2010).
Studies also show how OCD presents itself may vary between genders (to learn more about OCD subtypes click here). For example, females may experience more obsessions related to contamination or cleanliness. Males, on the other hand, are more likely to present with obsessions related to symmetry or exactness (Veale & Roberts, 2014). It is important to note that not all individuals will present with specific symptoms based off of the gender someone identifies with, however, studies simply suggest there is a higher likelihood of certain presentations.
Age of Onset: From Childhood to Later Life
While many individuals do not realize they have OCD until adulthood, it does not mean it only emerges in adulthood. Typical onset of OCD is often during late adolescents to early adulthood. However, there are also individuals who have their OCD emerge as children or older adults (Ruscio et al., 2010). For children, it is especially important to recognize signs of OCD to ensure early intervention and support.
Childhood-onset OCD, in particular, presents unique challenges due to developmental factors and may require specialized treatment approaches (Storch et al., 2011). Conversely, late-onset OCD in older adults may be associated with comorbidities and cognitive decline, necessitating tailored interventions (Mataix-Cols et al., 2020).
Ethnicity: Unraveling the Cultural Context
While there are studies on prevalence of ethnic groups with OCD, the research in this area is limited and can be seen as inconclusive (Subramaniam et al., 2013). This drives home the importance of not making assumptions about who may have OCD, because truly, we do not know all of the facts.
What we can do is acknowledge that factors such as cultural beliefs, stigma, and access to healthcare may influence the expression and recognition of OCD symptoms within diverse communities. As is the case in any relationship, professional or otherwise, cultural considerations are essential. In the case of OCD, it can help us understand how an individuals OCD manifests and their treatment preferences. An example of this would be that some cultural or religious beliefs may influence the content of obsessions, or the acceptability of certain treatment methods (Williams & Didie, 2016). Culturally sensitive approaches that respect individual values and beliefs are important in providing effective care for diverse populations.
Socioeconomic Status (SES): Beyond Financial Barriers
Individuals from all socioeconomic backgrounds can be affected by OCD. However, those from a lower socioeconomic background often face more barriers to accessing mental health resources (Fernandez de la Cruz et al., 2015). The association between SES and OCD is complex and influenced by various factors, including stress, trauma, and social support networks.
In addition, socioeconomic disparities may impact the course and outcome of OCD treatment. Individuals from marginalized communities may experience delays in diagnosis, limited treatment options, and higher rates of treatment discontinuation (Williams & Didie, 2016). Again, this can be the case for many mental health issues, not just OCD. Addressing socioeconomic inequalities in mental healthcare is essential for ensuring equitable access to OCD treatment and support services.
To acknowledge socioeconomic differences, some providers choose to offer some sliding scale spots or engage in programs like Pennsylvania’s Victims Compensation Assistance Program (VCAP). The goal is to ensure better access to mental health care, regardless of socioeconomic status. At this practice, I offer a limited sliding scale and participate as a VCAP provider.
Embracing Diversity in OCD
We do not have research on all areas of the demographics of OCD. However, we can surmise from what we do know that individuals with OCD have diverse and multifaceted backgrounds. By knowing this, we can challenge any stereotypes and assumptions about who experiences OCD. This can help us foster a deeper understanding and appreciation for the diversity of the individuals affected by this condition.
It is important for OCD treatment providers to adopt a holistic and culturally sensitive approach to OCD assessment and treatment. If you are a client, be sure you feel comfortable with your providers methods, ensuring they acknowledge you as more than just someone with OCD. While it is something you are seeking treatment for, it is not all of who you are. By embracing diversity and recognizing the unique experiences of each individual, we can strive towards more inclusive and effective mental healthcare practices as providers and clients.
******Please keep in mind that this blog post serves as a source of information, based on references and the writers’ professional experience, and should not replace professional medical or mental health advice or treatment from your primary providers.******
References:
Fernandez de la Cruz, L., Simonoff, E., McGough, J. J., Halperin, J. M., Arnold, L. E., Stringaris, A., & Mataix-Cols, D. (2015). Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: results from the multimodal treatment study of children with ADHD (MTA). Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 62–70. https://doi.org/10.1016/j.jaac.2014.10.010
Mataix-Cols, D., de la Cruz, L. F., Monzani, B., Rosenfield, D., Andersson, E., Pérez-Vigil, A., ... & Lenhard, F. (2020). D-Cycloserine augmentation of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders: A systematic review and meta-analysis of individual participant data. JAMA psychiatry, 77(2), 181-188.
National Institute of Mental Health. (n.d.). Obsessive-Compulsive Disorder (OCD). Retrieved from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63. https://doi.org/10.1038/mp.2008.94
Storch, E. A., Milsom, V. A., Merlo, L. J., Larson, M., Geffken, G. R., Jacob, M. L., ... & Goodman, W. K. (2011). Insight in pediatric obsessive-compulsive disorder: associations with clinical presentation. Psychiatry research, 188(2), 334-340.
Subramaniam, M., Soh, P., Vaingankar, J. A., Picco, L., Chong, S. A., & Lee, E. S. (2013). Quality of life in obsessive-compulsive disorder: impact of the disorder and of treatment. CNS Spectrums, 18(1), 21–33. https://doi.org/10.1017/S1092852912000790
Veale, D., & Roberts, A. (2014). Obsessive-compulsive disorder. BMJ, 348, g2183.
Williams, M. T., & Didie, E. R. (2016). Cultural adaptations of exposure therapy for obsessive-compulsive and related disorders: Suggestions for advancing treatment effectiveness. Cultural Diversity and Ethnic Minority Psychology, 22(1), 108–120. https://doi.org/10.1037/cdp0000049
