High rates of OCD symptom misidentification by mental health professionals

BACKGROUND: More than a decade may pass between the onset of obsessive-compulsive disorder (OCD) symptoms and initiation of treatment. One explanation may be health care professionals' limited awareness of OCD symptom presentations. We assessed mental health care providers' ability to identify taboo thoughts as manifestations of OCD.

METHODS: A random sample of 2,550 American Psychological Association members were asked to give diagnostic impressions based on 1 of 5 OCD vignettes: 4 about taboo thoughts and 1 about contamination obsessions.

RESULTS: Three-hundred sixty (14.1%) providers completed the survey. The overall misidentification rate across all vignettes was 38.9%. Rates of incorrect (non-OCD) responses were significantly higher for the taboo thoughts vignettes (obsessions about homosexuality, 77.0%; sexual obsessions about children, 42.9%; aggressive obsessions, 31.5%; and religious obsessions, 28.8%) vs the contamination obsessions vignette (15.8%).

CONCLUSIONS: Mental health professionals commonly misidentify OCD symptom presentations, particularly sexual obsessions, highlighting a need for education and training.