Obsessive-compulsive disorder: an exploration of some unresolved clinical issues.

The study data were obtained from a questionnaire survey of a South Australian community support group for obsessive-compulsive disorder (OCD). The response rate was 47%, yielding 81 questionnaire sets completed by members who, on the basis of their questionnaire responses, were judged to meet DSM-III-R criteria for OCD. The clinical and demographic characteristics of the respondents were very similar to those of previously reported clinical populations. Mean age at onset of OCD was 18 years and mean duration 17 years; 55% of respondents rated their current OCD as extremely or very severe. Seventy-seven percent had received psychiatric treatment (mean 55 occasions) and 47% had attended clinical psychologists or professional counsellors (mean 20 occasions). Those who reported prominent fears of losing control of motor behaviours had received a significant excess of outpatient and inpatient psychiatric treatment. Most respondents reported the presence of all 4 identified components of OCD, of which the obsession/rumination component was central. Levels of OCD correlated strongly with levels of overall psychopathology, and fertility rates were significantly reduced in those patients who reported the most symptoms.