Illness perception, help-seeking attitudes, and knowledge related to obsessive-compulsive disorder across different ethnic groups: a community survey.
OBJECTIVE
Despite similar prevalence rates across ethnicities, ethnic minorities with obsessive-compulsive disorder (OCD) are under-represented in research and clinical settings. The reasons for this disproportion have been sparsely studied. We explored potential differences in illness perception, help-seeking attitudes, illness knowledge, and causal attributions that could help explain the lower uptake of treatment for OCD amongst ethnic minorities.


METHODS
Two-hundred and ninety-three parents (139 White British, 61 Black African, 46 Black Caribbean, and 47 Indian) were recruited from the general population in South-East London, UK. Using a text vignette methodology, participants completed a survey including questions on illness perception, help-seeking attitudes, OCD knowledge, and causal attributions.


RESULTS
The groups did not differ in socio-demographic characteristics and family history of OCD. White British parents perceived that the OCD difficulties would have more negative impact on their children and that treatment would be more helpful, compared to the ethnic minorities; the largest differences were observed between White British and Indian parents. Ethnic minorities were more prone to say that would seek help from their religious communities. Black African parents were more in favor of not seeking help for the described difficulties and, in general, perceived more treatment barriers. White British parents seemed to be better informed about OCD than ethnic minority parents.


CONCLUSIONS
The results offer some plausible explanations for the large inequalities in access to services amongst ethnic minorities with OCD. Clinicians and policy-makers need to be aware of these socio-cultural factors when designing strategies to encourage help-seeking behaviors in these populations.
Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Gävlegatan 22 (Entré b), Floor 8, 11330, Stockholm, Sweden. lorena.fernandez.de.la.cruz@ki.se.|Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. lorena.fernandez.de.la.cruz@ki.se.
Lorena
http://orcid.org/0000-0002-1571-5485
L
Fernández de la Cruz
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Sarah
S
Kolvenbach
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Pablo
P
Vidal-Ribas
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
Amita
A
Jassi
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Marta
M
Llorens
National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
Natasha
N
Patel
Institute of Pharmaceutical Science, King's College London, London, UK.
John
J
Weinman
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Stephani L
SL
Hatch
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Dinesh
D
Bhugra
Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Gävlegatan 22 (Entré b), Floor 8, 11330, Stockholm, Sweden.|Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
David
D
Mataix-Cols
D000328:Adult; D044383:Black People / Q000523:psychology* / Q000706:statistics & numerical data; D017691:Caribbean Region / Q000208:ethnology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D009771:Obsessive-Compulsive Disorder / Q000208:ethnology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
Ethnic minorities; Health disparities; Help-seeking; Obsessive–compulsive disorder; Parental beliefs