Personal+and+Societal+costs+and+effects

"OCD impairs patients' quality of life. In a study of 60 patients, Koran, Thienemann and Davenport reported in 1996 that medication-free patients with moderate to severe OCD reported worse social functioning and performance in work and other activities than the general population than patients with diabetes. The more severe the OCD, the more impaired the patients' social functioning was, even after controlling for effects of concurrent depression. Moreover, Rasmussen and Eisen noted in 1992 that another indicator of reduced quality of life is lower likelihood of OCD patients marrying.The high personal cost of OCD is mirrored in high social costs. The estimated 1990 direct costs of OCD to the United States economy were $2.1 billion, and the indirect cost (i.e., lost productivity) $6.2 billion, reported in 1995. (Stanford School of Medicine). If a greater proportion of individuals with OCD were in treatment, the direct costs would have been considerable higher. For example, according to Nestadt et al. in 1994, among a random sample of the Baltimore study participants, only 1 of 15 individuals (7%) whom a psychiatrist judged to need treatment was receiving it. Rasmussen and Eisen reported in 1988 that the delay between symptom onset and first seeking care is often prolonged by a mean of seven years, while Marks in 1992 reported 10 years. Even with much treatment foregone, OCD accounted for almost 6% of the estimated 1990 cost of all mental illness. (Stanford School of Medicine). High social costs are also reflected in the high rates of unemployment in OCD patients and receipt of disability and welfare payments, reported Leon, Portera and Wissman in 1995. Family members suffer as well. Many studies indicate that patients' symptoms may create disharmony, angry or anguished demands for participating in rituals, a draining dependency, restricted access to rooms or living space, difficulty in taking holidays and interferences with work obligations", (Stanford School of Medicine).    Some 58% of OCD clients experience academic underachievement, 47% report occupational impairment, and 40% are unable to sustain long term employment. Further, anxiety disorders are often concurrent or comorbid with other mental illnesses, notably depression, that are secondary to an untreated anxiety disorder. In fact, the presence of an untreated anxiety disorder in youth is a risk factor for the development of depression and substance abuse in early adult years. (Anxiety Disorders Association of Canada, 2003) The high rates of comorbidity of anxiety with other disorders is also problematic as people with multiple diagnoses are more disabled and use more medical services than those without concurrent disorders.
 * Quality of Life**

Anxiety disorders are also more chronic than other groups of mental disorders, including affective disorders and substance use disorders, and disproportionately affect individuals from lower social classes. Anxiety disorders are associated with a tenfold increase in suicide risk. Anxiety disorders are common in their severe form, are often chronic, and constitute a substantial social burden, (Anxiety Disorders Association of Canada, 2003). .

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