To seek advice or not to seek advice about the problem: the help-seeking dilemma for obsessive-compulsive disorder

  • Amparo Belloch
  • Gema del Valle
  • Carmen Morillo
  • Carmen Carrió
  • Elena Cabedo
ORIGINAL PAPER

Abstract

Background

Although obsessive-compulsive disorder (OCD) is associated with considerable distress, it has been reported that OCD patients delay considerably in seeking treatment for their problem. The present study aimed to explore some variables hypothetically involved in the help-seeking process among OCD patients.

Methods

Twenty-six OCD patients without comorbid conditions completed the Interview of Help-Seeking, specifically designed for this study, which assesses to what extent patients delay seeking treatment for their problem, and three group of variables: factors influencing the recognition of the problem, reasons for delaying the treatment-seeking, and reasons for finally seeking treatment. Participants also completed OCD measures, as well as a questionnaire on thought control strategies.

Results

The mean length of delay in seeking treatment was 39.38 (SD = 50.95) months, and a great variety of reasons for delaying were observed. The OCD patients who delayed consultation longer, in comparison with patients who delayed less time, used fever social control strategies, and they were less aware of the interference and behavioral changes associated with the problem.

Conclusions

To gain more insight about the problem and to experience greater interference from the symptoms were determinants in the active search for help. Conversely, the main barriers to the help-seeking were the fears of stigma and the meaning of the thought contents. Additionally, the fact that patients are willing to disclose their obsessions to other people may favor an adequate representation of the problem and the need to seek mental health treatment.

Keywords

obsessive-compulsive disorder obsessions help-seeking insight 

References

  1. 1.
    Acarturk C, de Graaf R, van Straten A, Ten Have M, Cuijpers P (2008) Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking. A population based study. Soc Psychiatry Psychiatr Epidemiol 43:273–279PubMedCrossRefGoogle Scholar
  2. 2.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  3. 3.
    Avila A (1986) Una contribución a la evaluación de las obsesiones y compulsiones: revisión del inventario de obsesiones de Leyton (LOI) y del cuestionario obsesivo-compulsivo de Maudsley (MOCI). Psiquis 7:93–99Google Scholar
  4. 4.
    Belloch A, Morillo C, García-Soriano G (2007) Strategies to control unwanted intrusive thoughts: which are relevant and specific in obsessive-compulsive disorder? Cognitive Ther Res doi:10-1007/s.10608-007-9141-2
  5. 5.
    Clark DA (2005) Intrusive thoughts in clinical disorders. Theory research and treatment. Guilford Press, New YorkGoogle Scholar
  6. 6.
    Cruzado JA (1993) Tratamiento comportamental del TOC. Fundación Universidad-Empresa UNED, MadridGoogle Scholar
  7. 7.
    Di Nardo PA, Brown TA, Barlow DH (1994) Anxiety disorders interview schedule for DSM-IV: lifetime version (ADIS-IV-L). Graywind Publications Inc, New YorkGoogle Scholar
  8. 8.
    Galbaud du Fort G, Newman SC, Bland RC (1993) Psychiatric comorbidity and treatment seeking. J Nerv Ment Dis 181:467–474PubMedCrossRefGoogle Scholar
  9. 9.
    Goodman WK, Price LH, Ramussen SA et al (1989) The Yale-Brown obsessive-compulsive scale (II): validity. Arch Gen Psychiatry 46:1012–1016PubMedGoogle Scholar
  10. 10.
    Goodman WK, Price LH, Rasmussen SA et al (1989) The Yale-Brown obsessive-compulsive scale (I): development use and reliability. Arch Gen Psychiatry 46:1006–1011PubMedGoogle Scholar
  11. 11.
    Goodwin R, Koenen KC, Hellman F et al (2002) Helpseeking and access to mental health treatment for obsessive-compulsive disorder. Acta Psychiatr Scand 106:143–149PubMedCrossRefGoogle Scholar
  12. 12.
    Hodgson RJ, Rachman S (1977) Obsessional-compulsive complaints. Behav Res Ther 15:389–395PubMedCrossRefGoogle Scholar
  13. 13.
    Leaf PJ, Bruce ML, Tischler GL et al (1988) Factors affecting the utilization of specialty and general medical mental health services. Med Care 26:9–26PubMedCrossRefGoogle Scholar
  14. 14.
    Luciano JV, Belloch A, Algarabel S et al (2006) Confirmatory factor analysis of the white bear suppression inventory and the thought control questionnaire: a comparison of alternative models. Eur J Psychol Assess 22:250–258CrossRefGoogle Scholar
  15. 15.
    Mayerovitch JI, Galbaud du Fort G, Kakuma R et al (2003) Treatment seeking for obsessive-compulsive disorder: role of obsessive-compulsive disorder symptoms and comorbid psychiatric diagnoses. Compr Psychiatry 44:162–168PubMedCrossRefGoogle Scholar
  16. 16.
    Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood anxiety or substance abuse disorders. Arch Gen Psychiatry 59:77–84PubMedCrossRefGoogle Scholar
  17. 17.
    Newth S, Rachman S (2001) The concealment of obsessions. Behav Res Ther 39:457–464PubMedCrossRefGoogle Scholar
  18. 18.
    Purdon C, Clark DA (1994) Perceived control and appraisal of obsessional thoughts: a replication and extension. Behav Cogn Psychother 22:269–285CrossRefGoogle Scholar
  19. 19.
    Purdon C, Clark DA (1999) Metacognition and obsessions. Clin Psychol Psychother 6:102–110CrossRefGoogle Scholar
  20. 20.
    Rachman S (1997) A cognitive theory of obsessions. Behav Res Ther 35:793–802PubMedCrossRefGoogle Scholar
  21. 21.
    Rachman S, Hodgson RJ (1980) Obsessions and compulsions. Prentice Hall, New YorkGoogle Scholar
  22. 22.
    Rasmussen SA, Tsuang MT (1986) Clinical characteristics and family history in DSM-III obsessive-compulsive disorder. Am J Psychiatry 143:317–322PubMedGoogle Scholar
  23. 23.
    Robins LN, Helzer JE, Weissman MM et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 41:949–958PubMedGoogle Scholar
  24. 24.
    Roness A, Mykletun A, Dahl AA (2005) Help-seeking behaviour in patients with anxiety disorder and depression. Acta Psychiatr Scand 11:51–58CrossRefGoogle Scholar
  25. 25.
    Rosario-Campos MC, Leckman JF, Mercadante MT et al (2001) Adults with early-onset obsessive-compulsive disorder. Am J Psychiatry 158:1899–1903PubMedCrossRefGoogle Scholar
  26. 26.
    Salkovskis PM (1985) Obsessional-compulsive problems: a cognitive-behavioral analysis. Behav Res Ther 23:571–583PubMedCrossRefGoogle Scholar
  27. 27.
    Salkovskis PM (1999) Understanding and treating obsessive-compulsive disorder. Behav Res Ther 37:29–52CrossRefGoogle Scholar
  28. 28.
    Saunders SM (1993) Applicants’ experience of the process of seeking therapy. Psychotherapy 30:554–564Google Scholar
  29. 29.
    Sherwood C, Salkovskis PM, Rimes KA (2007) Help-seeking for depression: The role of beliefs attitudes and mood. Behav Cogn Psychother 35:541–554CrossRefGoogle Scholar
  30. 30.
    Simonds LM, Elliot SA (2001) OCD patients and non-patient groups reporting obsessions and compulsions: phenomenology help-seeking and access to treatment. Br J Med Psychol 74:431–449PubMedCrossRefGoogle Scholar
  31. 31.
    Simonds LM, Thorpe SJ (2003) Attitudes toward obsessive-compulsive disorders. An experimental investigation. Soc Psychiatry Psychiatr Epidemiol 38:331–336PubMedGoogle Scholar
  32. 32.
    Temkin-Greener H, Clark KT (1988) Ethnicity gender and utilization of mental health services in a medical population. Soc Sci Med 26:989–996PubMedCrossRefGoogle Scholar
  33. 33.
    Torres AR, Prince MJ, Bebbington PE et al (2006) Obsessive-compulsive disorder: prevalence comorbidity impact and help-seeking in the British national psychiatry morbidity survey of 2000. Am J Psychiatry 163:1978–1985PubMedCrossRefGoogle Scholar
  34. 34.
    Vanheusden K, van der Ende J, Mulder CL, van Lenthe FJ, Verhulst FC, Mackenbach JP (2008) The use of mental health services among young adults with emotional and behavioural problems: equal use for equal needs? Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s.00127-008-0367-4
  35. 35.
    Wang PS, Berglund P, Olfson M et al (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey replication. Arch Gen Psychiatry 62:603–613PubMedCrossRefGoogle Scholar
  36. 36.
    Wells A, Davies MI (1994) The thought control questionnaire: a measure of individual differences in the control of unwanted thoughts. Behav Res Ther 32:871–878PubMedCrossRefGoogle Scholar
  37. 37.
    Zimmerman M, Mattia JI (2000) Principal and additional DSM-IV disorders for which outpatientes seek treatment. Psychiatr Services 51:1299–1304CrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2008

Authors and Affiliations

  • Amparo Belloch
    • 1
    • 2
  • Gema del Valle
    • 3
  • Carmen Morillo
    • 4
  • Carmen Carrió
    • 3
  • Elena Cabedo
    • 5
  1. 1.Dept. of Personality Psychology, Faculty of PsychologyUniversity of ValenciaValenciaSpain
  2. 2.Depto. de Personalidad, Evaluación y Tratamientos PsicológicosFacultad de PsicologíaValenciaSpain
  3. 3.Mental Health Outpatient Clinic, Dept. 06Diputación de Valencia, USMValenciaSpain
  4. 4.Mental Health Outpatient Clinic, Dept. 05Agencia Valenciana de SaludValenciaSpain
  5. 5.Mental Health Outpatient Clinic, Dept. 05Agencia Valenciana de SaludValenciaSpain

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