OCD – Misunderstood and Misdiagnosed
The Center for Anxiety & OCD in Orlando| Specializing In Effective OCD Treatment
At The Center for Anxiety & OCD in Orlando, our highly trained OCD therapists specialize in evidence-based CBT and ERP (exposure and response prevention) for obsessive-compulsive disorder. Once thought to be a rare disorder, Obsessive Compulsive Disorder (OCD) is actually consistent and prevalent across all countries and cultures and affects approximately 2% of the population worldwide.
Despite many advances in neurophysiology, pharmacology and cognitive theories, OCD remains one of the most difficult psychological disorders to diagnose and treat. Studies have shown that misdiagnosis rates are very high among mental health professionals including psychiatrists, psychologists, psychotherapists and social workers and surprisingly even higher among pediatricians and primary care physicians. A recent study of 208 physicians at top hospitals in the greater New York area found that the misdiagnosis rate was over 50%.
A study of mental health professionals, of which 81.8% were doctoral-level psychologists and over 50% reported a CBT orientation, and who were all members of the American Psychological Association (APA) found that 15.8% misdiagnosed contamination obsessions, and 28.8% misdiagnosed religious obsessions. 42.9% of these professionals misdiagnosed sexual obsessions about children, with over a third misdiagnosing this type of OCD as pedophilia. In short, more common presentations of OCD such as fears of contamination or the need to order things perfectly were more often correctly diagnosed as OCD whereas OCD that focuses on taboo obsessions such as sexual, harm and religious obsessions were more often misdiagnosed.
Research has shown that individuals with religious and sexual obsessions were not correctly diagnosed with OCD for over seven years, even after having visited many different health care providers. Research also found that those who seek treatment for obsessive thoughts about sexual orientation were often inaccurately thought to be struggling with sexual identity issues instead of OCD. Adults and children with obsessive thoughts about self-harm or harming others were commonly misdiagnosed with suicidal or homicidal ideation, often resulting in hospitalization, which only serves to reinforce the individual’s fear that he or she is dangerous. Children who had intrusive sexual thoughts were often thought to have been abused, leading to excessive questioning and in some cases, reporting. Individuals who presented with thoughts of child molestation and pedophilia were often reported to authorities out of concern that they may harm a child.
Not surprisingly, an incorrect diagnoses can have devastating effects on adults and children with OCD as they are referred for treatments and/or medications that are intended for other conditions and receive ineffective therapy. A study found that doctors who correctly diagnosed an individual suffering with OCD would often recommend that the patient seek evidence-based treatment of Exposure and Response Prevention for OCD. Sadly, physicians and mental health providers often misdiagnosed individuals presenting with taboo mental obsessions with schizophrenia and these individuals were most often prescribed antipsychotic medications.
Similarly, OCD is often misdiagnosed as ADHD in children and teens as some of the symptoms associated with ADHD can look similar to OCD. Although ADHD and OCD have been found to be associated with very different types of brain activity, their cognitive effects are often quite similar as individuals with ADHD and OCD often underperform in executive function tests. Executive functions consist of mental skills that help one’s brain to pay attention, organize, plan, prioritize and make decisions. Studies have proposed that individuals who suffer with OCD experience an “overflow” of obsessive thoughts, which results in an overload of the executive functions system and thus leads to executive functioning problems. For example, if a child or teen with OCD sits in class and is mentally spending a great deal of time obsessing about germs on her desk, she is unable to pay attention to the teacher and would likely get lower grades. The teacher might think that this child or teen is inattentive and unable to concentrate and may suggest to the child’s parents that the child may have ADHD. So that the child could better focus in school, the child’s parents would likely visit the child’s pediatrician, who would likely prescribe ADHD medication after misdiagnosing the child with ADHD. Several research studies have found that ADHD medication actually increases obsessive-compulsive behaviors and thoughts and that stimulant medications may even induce them. Instead of getting better, the child or teen with OCD would likely get worse because she has been misdiagnosed.
OCD Awareness Week (October 9th – 15th 2016) encourages all of us to become more aware and gain a greater understanding of Obsessive-Compulsive Disorder. A misdiagnosis of OCD has the potential for serious consequences and can result in many negative outcomes, including inappropriate treatment, incorrect medication management, hospitalization and inaccurate reporting.
At the Center for Anxiety & OCD at GroundWork Counseling in Orlando our OCD clinicians specializes in diagnosing and treating OCD in both children and adults. When seeking OCD treatment it is important to find a qualified and trained therapist who has formal training in ERP and providing empirically supported treatment for OCD. Visit our list of questions to ask your perspective provider here: OCD Provider Questions.
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