Obsessive-compulsive disorder in the community : 12-month prevalence, comorbidity and impairment

Although subthreshold conditions are associated with impairment in numerous disorders, research on obsessive-compulsive disorder (OCD) below the diagnostic threshold of DSM-IV in the general population is limited. Estimate the DSM-IV 12-month prevalence, comorbidity and impairment of OCD, subthreshold OCD (i.e., fulfilling some but not all core DSM-IV criteria), and obsessive-compulsive symptoms (OCS) (i.e., endorsement of OCS without fulfilling any core DSM-IV criteria) in a general population sample. Data from the German National Health Interview and Examination Survey - Mental Health Supplement (N = 4181, age 18-65 years), based on the standardized diagnostic interview Munich Composite International Diagnostic Interview. The 12-month prevalence of OCD was 0.7%, subthreshold OCD was 4.5%, and OCS was 8.3%. Subjects in all three groups showed higher comorbidity (odds ratios [ORs] € ≥ 3.3), compared to those without OCS. OCD, subthreshold OCD and OCS were all associated with increased odds of substance abuse/dependence-, mood-, anxiety- and somatoform disorders, with especially strong associations with possible psychotic disorder (ORs € ≥ 4.1) and bipolar disorders (ORs € ≥ 4.7). Participants in all three groups showed higher impairment (ORs € ≥ 3.1) and health-care utilization (ORs € ≥ 2.4), compared to those without OCS, even after controlling for covariates. Individuals with subthreshold OCD and OCS, not currently captured by DSM-IV OCD criteria, nevertheless show substantial comorbidity, impairment and health-care utilization

How Prevalent Are Anxiety Disorders in Schizophrenia? A Meta-Analysis and Critical Review on a Significant Association

Objective: The presence of anxiety disorders (AD) in schizophrenia (SZ) is attracting increasing interest. However, published studies have yielded very broad variations in prevalence rates across studies. The current meta-analysis sought to (1) investigate the prevalence of co-occurring AD in SZ by reporting pooled prevalence rates and (2) identify potential sources of variations in reported rates that could guide our efforts to identify and treat these co-occurring disorders in patients with SZ. Methods: We performed a systematic search of studies reporting prevalence of AD in SZ and related psychotic disorders. Mean prevalence rates and 95% confidence intervals (CIs) were first computed for each disorder. We then examined the impact of potential moderators related to patient sampling or to AD assessment methods on these rates. Results: Fifty-two eligible studies were identified. Pooled prevalence rates and CIs were 12.1% (7.0%–17.1%) for obsessive-compulsive disorders, 14.9% (8.1%–21.8%) for social phobia, 10.9% (2.9%–18.8%) for generalized AD, 9.8% (4.3%–15.4%) for panic disorders, and 12.4% (4.0%–20.8%) for post-traumatic stress disorders. For all disorders, we found significant heterogeneity in rates across studies. This heterogeneity could at least partially be explained by the effect of moderator variables related to patient characteristics or assessment methods. Conclusions: AD are highly prevalent in SZ, but important variations in rates are observed between studies. This meta-analysis highlights several factors that affect risk for, or detection of AD in SZ, and could, thus, have an important impact on treatment and outcome of SZ patients