Quick question on OCD

[lammers1980]

I was just wondering what is the gender distribution of OCD patients? It seems like almost all of the OCD people I know are males. Do males make up the majority of patients with this condition?

 

[David Baxter]

Interesting question. My first thought was that I have met plenty of females with OCD and probably more females than males with the disorder. However, a quick check reveals that, while anxiety disorders and depression may be more prevalent in females than in males, prevalence of OCD is about equal:

Risk Factors for Obsessive-Compulsive Disorder (OCD)
Obsessive-compulsive disorder occurs equally in men and women, and it affects about 2% to 3% of people over a lifespan. About 80% of people who develop OCD show signs of the disorder in childhood, although the disorder usually develops fully in adulthood. The only group shown to be specifically at risk for OCD is women who have just given birth.

Incidence of OCD
For a long time, mental health professionals considered OCD to be a rare condition. That may be because OCD often has gone unrecognized. Many people who suffer from OCD are ashamed of their irrational behaviors and try to keep their problem a secret. But in recent years, as science has confirmed that OCD is a potentially severe anxiety disorder, more people have begun to seek treatment.

OCD, in fact, affects more than 2.3% of the U.S. population between the ages of 18-54, according to the National Institute of Mental Health (NIMH). According to the Mayo Clinic, an estimated 3.3 million Americans have obsessive-compulsive disorder. That makes OCD more common than schizophrenia, bipolar disorder, or panic disorder. In addition, OCD is an "equal opportunity" illness, striking people of all ages, gender, and ethnic groups.

On the other hand, there do appear to be some differences in the way OCD affects males vs. females:

Gender in obsessive-compulsive disorder: clinical and genetic findings.

Lochner C, Hemmings SM, Kinnear CJ, Moolman-Smook JC, Corfield VA, Knowles JA, Niehaus DJ, Stein DJ.

MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa. cla@sun.ac.za

Compared with females, males with OCD (1) had an earlier age of onset, and a trend toward having more tics and worse outcome, (2) had somewhat differing patterns of OCD symptomatology and axis I comorbidity, and (3) in the Caucasian group, were more likely to have the high activity T allele of the EcoRV variant of the monoamine oxidase A (MAO-A) gene compared to controls, and (4) in the Afrikaner subgroup, were more frequently homozygous for the C allele at the G861C variant of the 5HT(1D beta) gene than controls. Females with OCD (1) reported more sexual abuse during childhood than males, (2) often noted changes in obsessive-compulsive symptoms in the premenstrual/menstrual period as well as during/shortly after pregnancy, and with menopause, and (3) in the Caucasian subgroup, were more frequently homozygous for the low activity C allele of the EcoRV variant of the MAO-A gene compared to controls, with this allele also more frequent in female patients than controls.
Eur Neuropsychopharmacol. 2004 Mar;14(2):105-13.

Gender-related clinical differences in obsessive-compulsive disorder.

Bogetto F, Venturello S, Albert U, Maina G, Ravizza L.

Department of Neurosciences, Psychiatric Unit, University of Turin, Via Cherasco 11, 10126 Turin, Italy.

We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

Eur Psychiatry. 1999 Dec;14(8):434-41.