ABSTRACT

Until recently, obsessive-compulsive disorder (OCD) could well be considered an invisible illness. The prevalence of OCD has historically been underestimated. Rudin (1953) estimated the lifetime prevalence of OCD to be 0.05 percent. Recent estimates based on the Epidemiological Catchment Area (ECA) Survey suggest a much higher lifetime prevalence of 2.5 percent (Robins et al., 1984), making it about twice as common as panic disorder and schizophrenia, and the fourth most common psychiatric disorder in the United States (Karno et al., 1988). Rasmussen and Eisen (1990) suggest a number of reasons for the failure to identify OCD symptoms. One of these reasons is that many clients are reluctant to talk about their symptoms for fear of seeming “crazy” or bizarre. Pollard and colleagues (1989) found that only 28 percent of individuals with OCD in the general population sought help for the illness. Another reason for the underreporting of OCD suggested by Rasmussen and Eisen (1990) is that many clinicians focus on underlying comorbid disorders, such as depression and anxiety, and fail to ask appropriate screening questions to identify OCD symptoms.