Help-seeking for obsessions and compulsions
Background: Obsessions and compulsions are the two core features of Obsessive-Compulsive Disorder (OCD). Mild and infrequent obsessions and compulsions are common. Persistent and distressing obsessions and compulsions of the kind seen in OCD occur in far fewer people. As is the case with other psychiatric disorders, many people with OCD do not seek help. Clinical observation suggests that help-seeking delay in OCD is substantial, averaging eleven years. A proliferation of research studies of non-OCD patient participants has arisen from the observation that some people in community settings have clinically significant obsessions and compulsions. Conversely, there is little research that considers why people with obsessions and compulsions delay help-seeking and why this morbidity may be missed. Aims: This thesis examined attitudes to obsessive-compulsive (OC) problems, the existence of obsessions and compulsions in non-psychiatric groups, the profile of OC features in a clinical OCD group, and the help-seeking and treatment experiences of people with OCD. Its primary focus was to discover barriers to disclosing obsessions and compulsions in order to seek help. Findings: Dermatology and obstetric outpatients and students exhibited obsessions and compulsions comparable to those evidenced by people with OCD. The content of an OC problem influenced judgements of fear and shame about disclosing the problem. People with OCD delayed seeking help because of fear, shame and lack of knowledge. Concealment had occurred in the hope that the problem would go away, or from fear of the reaction of others. Feelings of embarrassment and shame were pervasive. Implications: Continued research on public attitudes to OC problems and on the help-seeking experiences of people with such problems is necessary. Raising public awareness of obsessions and compulsions and their treatment may reduce stigma and fear. Ultimately, concealment is problematic for the person with obsessions and compulsions, and for the conceptualisation of OCD.