image: Severity of role impairment due to obsessions/compulsions by SDS category: household duties (A), work (B), relationship (C), social life (D) and any domain (E). O/C, obsessions/compulsions; SDS, Sheehan Disability Scale; 1, one symptom; 2, two symptoms; 3, three symptoms; 4, four symptoms; 5, five or more symptoms.
Credit: Bangshan Liu, Junzhe Cheng, Zhaorui Liu, Yueqin Huang, Shazia Rehman, Minxue Shen, Jin Liu, Yumeng Ju, Yaqin Yu, Xiufeng Xu, Zhizhong Wang, Yifeng Xu, Tao Li, Guangming Xu, Xiangdong Xu, Limin Wang, Yongping Yan, Shuiyuan Xiao, Tingting Zhang, Jie Yan, Lingjiang Li, Huifang Yin, Yan Zhang.
As there is a lack in standardized screening tools and under-detection of obsessive–compulsive disorder (OCD) in China, a new nationwide study published in General Psychiatry offers the first comprehensive, nationally representative overview of OCD and related healthcare utilization, which reveals that OCD is prevalent, highly disabling, and rarely treated.
Drawing on data from the China Mental Health Survey, researchers analysed face-to-face diagnostic interviews with 28,140 adults from 157 disease surveillance points across 31 provinces.
The weighted lifetime and 12-month prevalence rates were 2.43% and 1.63%, respectively, comparable to those in high-income countries and much higher than previous Chinese estimates, which were limited by methodological flaws. Prevalence showed no significant difference by age, gender, residence or education, though individuals who were separated, widowed, or divorced had a notably higher lifetime prevalence (4.06%).
Obsessive–compulsive symptoms were more common than full OCD, with 14.28% of adults reporting at least one obsession or compulsion. The conditional probability of OCD rose sharply with the number of symptoms, exceeding 36% among those with five or more symptoms. Comorbidity was widespread: 66.69% of respondents with lifetime OCD had at least one additional mental disorder, most often mood disorders (39.67%) and anxiety disorders (32.75%), both of which showed strong associations with OCD in regression analyses. For many individuals, OCD emerged after the onset of other mental disorders, especially anxiety-related conditions.
Functional impairment was common. 58.19% of respondents with obsessions or compulsions experienced impairment in household, work, relationship or social domains, with severity increasing alongside the number of symptoms. “Other” obsessions and compulsions produced the greatest impairment, while compulsive checking was linked to relatively less disruption.
"We found that respondents with obsessive checking, compulsive contamination and 'other' obsessions and compulsions, which caused the most severe role impairment, had the highest conditional probability of lifetime OCD and the highest rate of healthcare utilisation for any O/C dimension." lead author Bangshan Liu noted "These findings indicate that it is essential to consider the multidimensional and heterogeneous characteristics of obsessive and compulsive symptoms."
Despite the heavy burden, healthcare utilisation was extremely low: only 6.74% of individuals with lifetime OCD had ever sought treatment, with an average delay of more than 10 years between onset and first treatment. The authors call for expanded mental health services, improved public awareness, and updated DSM-5-based national surveys.
Journal
General Psychiatry
Method of Research
Experimental study
Article Title
Prevalence of obsessive-compulsive disorder and related healthcare utilisation in China: a cross-sectional epidemiological survey
Article Publication Date
12-Nov-2025