Mental Health Literacy Concerning Categories of Obsessive-Compulsive Symptoms

Abstract

Objective: Despite the considerable distress and disability, many obsessive-compulsive disorder (OCD) sufferers usually are not inclined to seek health care due to their poor mental health literacy. The concept of "mental health literacy" is defined as the knowledge, beliefs, and attitudes related to the recognition, management, and prevention of psychiatric disorders. We aimed to investigate mental health literacy concerning different obsessive-compulsive symptoms in a community sample. Methods: The sample consisted of 376 healthy subjects. They were given vignettes describing four cases with different symptom categories of obsessive-compulsive disorders (aggressive obsessions and related compulsions, contamination obsessions and related compulsions, religious obsessions and related compulsions, and ordering-arranging-counting obsessions and related compulsions), based on factor analytic studies. Each vignette was followed by 17 questions about problem recognition, causes, care alternatives and stigma-shame. Results: When comparing the different categories, the participants were significantly more likely to rate the aggressive category as an abnormal condition and to associate it with stressful life events; to rate the aggressive and contamination categories as signs of mental disorder and to associate them with medical causes; and to rate religious category as a religious problem, and seeing a religious healer was the preferred care-seeking behavior. Significantly more participants noted that they would hide aggressive and religious category symptoms from their family members and co-workers, and would feel shame. Participants were more likely to hold stigmatizing attitudes towards persons with symptoms of contamination category. Conclusion: These findings suggest that the presence of different phenomenological characteristics of OCD may influence health care-seeking behavior in complex ways, due to mental health literacy. While social environment provides a bearable, acceptable or suitable atmosphere for a number of psychiatric problems, some problems might be less tolerated in the sociocultural context. (Archives of Neuropsychiatry 2010; 47: 133-8)