Obsessive-compulsive disorder and the underlying structure of anxiety disorders in a nationally representative sample: Confirmatory factor analytic findings from the German Health Survey

The current study is the first to examine the underlying structure of anxiety disorders, including obsessive-compulsive disorder (OCD), to use professional clinical interviewers (psychologists), and to examine past-year rather than lifetime diagnoses. A confirmatory factor analysis was performed using diagnoses from a nationally representative mental health survey in Germany based on face-to-face structured clinical interviews (conditional response rate 87.6%). Participants were 4181 adults. The diagnosis of OCD is loaded on an Anxious-Misery factor. Our results revealed several unique findings and extend previous epidemiologic work in this area. A major clinical implication of the current study is that the diagnosis of OCD should be conceptualized as part of an Anxious-Misery factor defined primarily by GAD, PTSD, depression, and dysthymia rather than part of a higher-order Fear factor defined primarily by panic and phobic disorders.