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Brief Reports   |    
Treatment of Obsessive-Compulsive Disorder in a Nationwide Survey of Office-Based Physician Practice
Sapana R. Patel, Ph.D.; Jennifer L. Humensky, Ph.D.; Mark Olfson, M.D.; Helen Blair Simpson, M.D., Ph.D.; Robert Myers, Ph.D.; Lisa B. Dixon, M.D., M.P.H.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300192
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Except for Dr. Myers, the authors are with the New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City (e-mail: sp2309@columbia.edu). Dr. Myers is with the New York State Office of Mental Health, New York City.

Copyright © 2014 by the American Psychiatric Association


Objective  This study examined treatment of obsessive-compulsive disorder (OCD) in office-based practice.

Methods  Data from the 2003–2010 National Ambulatory Medical Care Survey, a nationally representative survey of visits to U.S. office-based physicians, were used to examine outpatient visits involving treatment of adults with OCD.

Results  Among the 316 visits with a diagnosis of OCD, most were to a physician seen previously by the patient (96%), usually a psychiatrist (86%), and most patients (56%) had seen the physician at least six times in the previous year. Most visits included psychotropic medications (84%), most commonly a serotonin reuptake inhibitor (SRI) (69%). Visits less commonly included psychotherapy (39%).

Conclusions  OCD was predominantly treated by psychiatrists using SRIs, despite the prevalence of OCD in primary care and SRI prescribing practices in that setting. Given the potential shift in OCD treatment patterns after health care reform, research on OCD treatment in primary care is warranted.

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Table 1Characteristics of office-based visits (N=316) by patients with obsessive-compulsive disorder, 2003–2010a
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a Data are from the 2003–2010 National Ambulatory Medical Care Survey. Percentages are weighted and based on survey-corrected sampling.

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b Medicare, Medicaid, and other government insurance

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c Includes no charge, uncompensated care, workers' compensation, and unknown payment

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d Includes general surgery, cardiovascular diseases, neurology, and a residual category of all other specialties

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e Psychotherapy visits were limited to those lasting at least 45 minutes.

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f SRI, serotonin reuptake inhibitor

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g Includes tricyclics and tetracyclics and other antidepressants



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