Obsessive-compulsive disorder prevalence

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The mood and anxiety disorders in their various permutations constitute a major source of personal suffering and impaired ability to engage in productive Avork and interpersonal relationships. Between 5 and 9% of women and between 2 and 3% of men meet the diagnostic criteria for major depression at any time 10-25% of all women suffer major depression sometime in their lives, while 5-10% of men will develop major depressive disorder (American Psychiatric Association, 1994). The anxiety disorders obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, and generalized anxiety disorder (GAD) show lifetime prevalence rates of approximately 2.5%, 7%, 2.5%, and 5% respectively. Between 3 and 13% of individuals in community samples are regarded to meet the diagnostic criteria for social phobia. Mood and anxiety disorders are common comorbidities (American Psychiatric Association, 1994) and the most common antidepressant medications including the serotonin reuptake inhibitors, the mixed serotonin-catecholamine reuptake inhibitors, the tricyclic antidepressants, and the monoamine oxidase inhibitors, are all effective treatments for anxiety and panic attacks. 

Obsessive-compulsive disorder (OCD) involves recurrent obsessions and compulsions, which are severe enough to cause marked distress and major functional impairment. The sufferer is aware that the obsessions and com-pulsionsare unreasonable, but is powerless to stop them. Obsessions are recurrent, unwanted thoughts or images, whereas compulsions are repetitive acts or rituals. The individual typically feels compelled to perform compulsions to alleviate the anxiety associated with an obsession, or to prevent the occurrence of some dreaded event. The lifetime prevalence of OCD is estimated at 2.3% (14). 

Psychiatric comorbidity is common, as up to 75% of patients have a primary mood disorder. A link between AN and anxiety disorders, especially social phobia (fear of eating in public) and obsessive-compulsive disorder, has been noted. The lifetime prevalence of obsessive-compulsive disorder in patients with AN is reported to be as high as 25%, much higher than the lifetime prevalence in the general population (2.5%). Personality disorders are also more common among people with AN, especially the avoidant and obsessive-compulsive types, than in the general population. ... 

Introduced in 1988, Prozac is the oldest in the SSRI class and is still the most commonly prescribed (Morris, 1999). Prozac is a highly successful antidepressant that has revolutionized the treatment of depression because of its ability to raise serotonin levels in the brain. Increased availability of this neurochemical has been directly related to addressing effectively the symptoms prevalent in depression, and Prozac was recently approved to treat obsessive-compulsive disorder and the eating disorder bulimia. Prozac and the other SSRIs are also considered the medication of choice for working with depressed older individuals because of fewer side effects than the tricyclic medications (Haider Miller, 1993). In 1999 Prozac was endorsed by the FDA as being especially effective for geriatric depression (Hussar, 2000). 

The development of mild forms of anxiety and neuroveg-etative and/or cognitive responses to stress may represent an adaptive evolutionary step against environmentally (external) or self-triggered (internal) threats, but maladaptive reactions have also emerged in human evolution. Thus, anxiety disorders are maladaptive conditions in which disproportionate responses to stress, or even self-evoked responses, are displayed. Anxiety disorders are one of the most frequent psychiatric illnesses, and have a lifetime prevalence of 15- 20% [1, 89]. The most common presentations are generalized anxiety disorder, with a lifetime prevalence rate of close to 5% [1, 89] social anxiety disorder, with very variable lifetime prevalence rates ranging from 2 to 14% [90] panic disorder, with rates from 2 to 4% [1,89] and post-traumatic stress disorder (PTSD), with a prevalence rate close to 8%. Specific phobias, acute stress and obsessive-compulsive behavior are other clinical presentations of anxiety disorders. 

The association with Gilles de la Tourette s disorder is particularly important. Although only a few OCD patients have tics, the prevalence is much higher than in the general population. Conversely, obsessive-compulsive symptoms are common in Tourette s patients. Thus, there is a clear association between Tourette s disorder and OCD. Tourette s is familial, and most likely genetically transmitted ( 157). Less is known about the heritability of OCD, but there is some suggestion that it is, at least in part, genetically determined (158, 159 and 160). 

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