Treatment-seeking in OCD community cases and psychological treatment actually provided to treatment-seeking patients: A systematic review

• Studies so far indicate that a majority of OCD patients never seek help for this disorder.
• Cognitive-behavioral therapy including exposure and response prevention is underutilized in OCD.
• There is a gap between the proven efficacy of cognitive-behavioral therapy in OCD and its role in actual treatment histories.

This article systematically reviews the literature on (a) the proportions of treatment-seeking OCD patients in community-based studies as well as on (b) the proportion of cognitive-behavioral therapy (CBT) or behavior therapy (BT) administered in OCD as reported in studies based on treatment-seeking populations. The literature search was conducted in PsycInfo and PubMed. Inclusion criteria were: (1) studies for which adult subjects with an OCD diagnosis were recruited (2) n>10 (3a) studies with data on the percentage of individuals seeking treatment for OCD symptoms in OCD subsamples of community studies or (3b) studies with data on the percentage of patients in treatment-seeking OCD populations receiving cognitive-behavioral therapy (CBT) or behavior therapy (BT) (4) publication written in English, German, French, Spanish, Portuguese or Italian. 20 articles met these criteria, 12 for part (a), and 8 for part (b) of the review. Findings indicate that a majority of OCD sufferers never seek help for this disorder. Moreover, only a minority of treatment-seekers with OCD seems to receive cognitive-behavioral therapy including exposure techniques. Studies with representative OCD patient samples are urgently needed to shed more light on the actual treatment situation, and to derive measures for the prevention of negative long-term outcome.