Patient Perceptions of Illness Causes and Treatment Preferences for Obsessive-Compulsive Disorder: A Mixed-Methods Study.

Journal: Culture, medicine and psychiatry

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Affiliated Institutions:  Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, USA. neil.aggarwal@nyspi.columbia.edu. New York State Psychiatric Institute, New York, USA. Department of Clinical Psychology and Psychotherapy, Goethe University, Frankfurt, Germany. SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa. Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Obsessive-Compulsive Spectrum Disorders Program, LIM-, Instituto de Psiquiatria do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, USA.

Abstract summary 

Obsessive-compulsive disorder (OCD) is a condition with high patient morbidity and mortality. Research shows that eliciting patient explanations about illness causes and treatment preferences promotes cross-cultural work and engagement in health services. These topics are in the Cultural Formulation Interview (CFI), a semi-structured interview first published in DSM-5 that applies anthropological approaches within mental health services to promote person-centered care. This study focuses on the New York City site of an international multi-site study that used qualitative-quantitative mixed methods to: (1) analyze CFI transcripts with 55 adults with OCD to explore perceived illness causes and treatment preferences, and (2) explore whether past treatment experiences are related to perceptions about causes of current symptoms. The most commonly named causes were circumstantial stressors (n = 16), genetics (n = 12), personal psychological traits (n = 9), an interaction between circumstantial stressors and participants' brains (n = 6), and a non-specific brain problem (n = 6). The most common treatment preferences were psychotherapy (n = 42), anything (n = 4), nothing (n = 4), and medications (n = 2). Those with a prior medication history had twice the odds of reporting a biological cause, though this was not a statistically significant difference. Our findings suggest that providers should ask patients about illness causes and treatment preferences to guide treatment choice.

Authors & Co-authors:  Aggarwal Neil Krishan NK Sadaghiyani Shima S Kananian Schahryar S Lam Peter P Messner Gabrielle G Marincowitz Clara C Narayan Madhuri M Luciano Alan Campos AC van Balkom Anton J L M AJLM Hezel Dianne D Lochner Christine C Shavitt Roseli Gedanke RG van den Heuvel Odile A OA Simpson Blair B Lewis-Fernández Roberto R

Study Outcome 

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Statistics
Citations :  Adam, Y., Meinlschmidt, G., Gloster, A. T., & Lieb, R. (2012). Obsessive–compulsive disorder in the community: 12-month prevalence, comorbidity and impairment. Social Psychiatry and Psychiatric Epidemiology, 47(3), 339–349.
Authors :  15
Identifiers
Doi : 10.1007/s11013-024-09865-5
SSN : 1573-076X
Study Population
Male,Female
Mesh Terms
Other Terms
Cultural competence;Cultural formulation interview;Cultural psychiatry;Explanatory models;Obsessive-compulsive disorder
Study Design
Study Approach
Mixed Methods
Country of Study
Publication Country
Netherlands