OBJECTIVE: This study attempted to document a hypothesized increase in
the frequency of the diagnosis of obsessive-compulsive disorder at a large
psychiatric teaching hospital and to investigate correlates of this trend.
METHOD: The annual rates of psychiatric discharge diagnoses at the hospital
from 1969 to 1990 were reviewed, and the frequency of the diagnosis of
obsessive-compulsive disorder was compared with that of paranoid disorders.
Correlations were also done on these diagnostic rates and the rates of
reports in the literature in the same years on each of these types of
disorders and their treatment. RESULTS: The frequency of the diagnosis of
obsessive-compulsive disorder, but not paranoid disorders, increased
markedly during the 1980s. This increase was associated strongly and
selectively with increases in publications about that disorder,
particularly reports on drug and behavior therapy. CONCLUSIONS: There has
been a large recent increase in the rate of diagnosis of
obsessive-compulsive disorder, evidently associated with advances in the
study and treatment of the disorder. The observations suggest the influence
of a treatment-oriented diagnostic bias in which clinicians may more
readily consider and diagnose a condition for which an innovative or
effective treatment is available.