Receiving the right psychiatric diagnosis can be life-changing, yet for many sufferers of obsessive-compulsive disorder (OCD), this clarity comes years after symptoms first appear. Recent revelations and mounting research highlight the widespread misdiagnosis of OCD as general anxiety disorder—a trend that has profound consequences for mental health treatment across the globe, including in Thailand.
The latest publicised case is recounted by a UK health reporter whose experiences echo the challenges many OCD patients face. For years, the journalist’s persistent, distressing intrusive thoughts were brushed aside as “just anxiety” by doctors and therapists. Only after seeking specialist help, and on the advice of an OCD-trained psychologist, did she receive an accurate diagnosis—a development that she described as “life-changing” (Daily Mail).
Why does this matter to Thai readers? OCD is a serious mental disorder that impairs quality of life and elevates the risk of suicide and other health complications. Despite this, both in the West and in Thailand, public and medical misunderstanding of OCD remains commonplace. Stereotypes about OCD focus on cleanliness or perfectionism, causing less obvious forms—such as “pure O” (primarily obsessional OCD characterised by intrusive thoughts without visible compulsions)—to be overlooked or misdiagnosed as anxiety disorders (Wikipedia). Inaccurate diagnosis delays effective treatment, prolongs patient suffering, and increases the risk of severe outcomes.
Key facts from recent research underscore the gravity of the issue: According to a 2024 review, as many as 50% of OCD cases are misdiagnosed by general physicians, with years often passing before sufferers receive targeted interventions (NOCD statistics; ResearchGate systematic review). One widely cited international study found it takes an average of nine years for OCD to be recognized by an expert—time in which patients may develop further complications, including depression, eating disorders, or social withdrawal (iNews report).
In Thailand, there is evidence that both awareness and measurement of OCD are increasing, especially in high-stress populations such as medical students where recent screening found symptoms present in up to 26.7% (JPAT study). Clinician interviews reveal that, like elsewhere, Thai patients often receive initial diagnoses of generalized anxiety or depression when they present with intrusive thoughts—a symptom profile that, if misunderstood, may attract social stigma or inappropriate therapy.
Experts stress that OCD and anxiety disorders, though related, are distinct conditions needing different approaches. OCD is marked by persistent, intrusive thoughts (“obsessions”) that drive the urge to perform certain mental or physical actions (“compulsions”) in an attempt to relieve anxiety. Notably, “pure O” or mental OCD features mostly mental rituals—such as repetitive checking of one’s own memories or morality—which makes the condition especially difficult to spot.
Professor of psychiatry at a leading UK hospital explains, “The nature of worry in generalized anxiety disorder focuses on plausible everyday problems like work or relationships. OCD fears, in contrast, are catastrophic and frequently go against the person’s values, which is why the thoughts are so distressing and shameful.” Failure to recognize these differences can result in unsuitable treatments. Standard cognitive behavioral therapy (CBT), the gold standard for anxiety, may actually worsen OCD symptoms unless tailored with exposure and response prevention (ERP)—a therapy specifically designed for OCD (National Institutes of Health review).
A Thai psychiatrist specializing in anxiety and obsessive-compulsive disorders observes, “Thai clients commonly describe intense distress about intrusive thoughts but may not display visible compulsions. Family members and general practitioners often encourage standard anxiety therapy, but this rarely alleviates OCD effectively.”
The impact of misdiagnosis is significant: Without proper treatment, people with OCD are five times more likely to die by suicide, and face higher risks of worsened physical health—including heart disease and hormonal disorders (Karolinska Institute study summary via Daily Mail). Social isolation, a known risk in Thai communities due to stigma attached to mental health issues, is both a consequence and contributor to the risks.
Thailand-specific data shows OCD is likely under-recognized. Studies using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) Thai version provide a clearer portrait of OC symptoms, showing diversity in obsessions and compulsions within Thai populations (PMCID). But there remains a gap in validated screening for children and adolescents, suggesting that future generations may still be under-diagnosed, particularly if their symptoms do not fit common stereotypes (Chulalongkorn Medical Journal).
■ Historical and cultural context plays a major role in shaping both stigma and recognition of psychiatric illness in Thailand. Thai traditions emphasize maintaining “face” and social harmony, making discussion of taboo intrusive thoughts especially difficult. Furthermore, Buddhist teachings about mindfulness and detachment can sometimes be interpreted in ways that unintentionally reinforce obsessive rumination, if misunderstood. However, these same cultural values can also be harnessed to support destigmatizing conversations—especially if linked to support from respected healthcare professionals or monks involved in community mental health initiatives.
Looking ahead, experts forecast several critical trends: First, greater public education campaigns are needed to dismantle stigma and teach that OCD is more than just “being neat” or “perfectionistic.” Increased use of digital tools and self-assessment apps may help Thai patients recognize their own symptoms earlier. There is also growing interest in genetic research, with recent international studies revealing strong links between OCD and anxiety, depression, anorexia, and Tourette’s syndrome (The Conversation), underscoring the complexity of getting the diagnosis right.
Most importantly, Thai psychiatrists and primary care doctors must receive specific training in the differentiation of OCD and anxiety, and ensure that evidence-based treatments—including ERP therapy and high-dose selective serotonin reuptake inhibitors (SSRIs)—are accessible (Wikipedia; NIH PMC review). Community awareness, support groups, and early intervention in schools are practical steps that can reduce long-term suffering and save lives.
In summary, the latest research and personal narratives highlight a critical truth: OCD is a chronic, often misunderstood condition that requires careful diagnosis and specialized treatment. Thai readers—whether health professionals, patients, or family members—are urged to seek expert advice where anxiety and intrusive thoughts do not improve with standard approaches. Early recognition and proper therapy can transform lives, strengthening both individuals and Thai society as a whole.
Practical recommendations: If you or someone you know struggles with persistent, distressing thoughts or repetitive behaviors, consult a mental health specialist trained in OCD. Do not settle for standard anxiety treatments without first considering whether OCD-specific therapy such as ERP might be more effective. For families, be supportive and avoid shaming comments, and help create an open environment for discussion. Thai healthcare practitioners should update their knowledge of the latest OCD guidelines and screening tools, and advocate for integrated mental health policies that include OCD awareness.
Citations:
- Daily Mail: Accurate OCD Diagnosis Story
- Wikipedia – Obsessive-Compulsive Disorder
- OCD Misdiagnosis Statistics – NOCD
- Obsessive-Compulsive Disorder Review – NIH PMC
- Genetic Links to OCD – The Conversation
- Prevalence Study in Thai Medical Students – JPAT
- Validity of Thai OCD Scales – PMC
- Children’s OCD Screening in Thailand – Chulalongkorn Med J PDF
- Misdiagnosis Leading to Severe Outcomes – iNews
- OCD Suicidality Risks – Daily Mail, Karolinska Institute