Recognition of Obsessive-Compulsive Disorder by Non-Specialist Health Workers in India: Treatment Delay as a Modifiable Outcome : A Narrative Review
Year: 2026
Type: review
Abstract: Background: Obsessive-compulsive disorder (OCD) is a treatable mental health condition frequently recognised late. Patients often first present to general health settings, where non-specialist health workers play a crucial role in early identification. Objective: To synthesise evidence on treatment delay in OCD, examine barriers to recognition in non-specialist settings, and assess the potential role of the general health workforce in reducing delays in the Indian context. Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar to identify literature published between 2005 and 2025. Search terms included OCD, duration of untreated illness, help-seeking, recognition, misdiagnosis, mental health literacy, health workers, nurses, and India. Relevant national survey reports were also reviewed. Studies were selected based on relevance rather than systematic eligibility criteria. Findings: Pooled estimates indicate a mean age at help-seeking of 28.66 years, compared with an onset age of approximately 19.5 years, with a pooled duration of untreated illness of 80.23 months. Prolonged untreated illness is associated with poorer treatment response. Under-recognition, symptom concealment, and professional misdiagnosis contribute to delays. In India, an estimated 84.5% treatment gap for mental disorders and psychiatrist availability of approximately 0.3 per 100,000 population highlight the importance of non-specialist healthcare providers. Mental compulsions, scrupulosity, and intrusive postnatal aggressive thoughts may be particularly difficult to recognise. Conclusion: Evidence on OCD knowledge among Indian non-specialist health workers remains limited. Integrating symptom recognition, brief screening, and cadre-specific training into general healthcare may improve early identification. Descriptive research is urgently needed to establish baseline knowledge and inform targeted interventions.
Author: Jayamala S Goudar
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W7225011486