Sociodemographic, mental health, education, employment and income characteristics of adults with obsessive-compulsive disorder who accessed secondary health services in Aotearoa | New Zealand.

Little is known about New Zealanders who experience obsessive-compulsive disorder (OCD). Using population-level data for people aged 18-64 years, we identified a cohort of 5559 people who accessed secondary health services and had a diagnosis of OCD. We explored their characteristics in comparison to people without OCD. The rate of OCD per 10,000 people differed by ethnicity (European, 24.7; Māori, 13.4; Pacific Peoples, 5.6; Asian, 5.9). We observed variation in OCD rates by the geographic divisions of the public healthcare provider Health NZ which persisted following standardisation for age, sex, ethnicity and urban vs rural residence (Northern, 14.5; 95% confidence interval (CI) 13.7-15.2; Te Manawa Taki, 10.9; CI 10.0-11.8; Central, 19.7, CI 18.5-20.8; Te Waipounamu, 27.4, CI 26.2-28.7). These disparities suggest inequity of access to healthcare. Individuals in this cohort typically had at least one co-occurring mental health or related condition (78.8%) and were less likely to have at least level 4 educational qualifications (equivalent to first year of an undergraduate degree) (adjusted rate ratio (ARR) 0.94; CI 0.90-0.97), to be employed (ARR 0.69; CI 0.66-0.72) and to belong to a higher income bracket ($40,000 or higher, ARR 0.57; CI 0.53-0.62). These findings suggest wider support needs. What we already know: Obsessive-compulsive disorder (OCD) is a mental health condition that is characterised by repetitive intrusive thoughts and compulsive behaviours and has a twelve-month prevalence of around 1-2% in adults.In clinic-based studies, most individuals with OCD have other mental health and related conditions and, to a lesser degree, this is also observed in community surveys.OCD is typically first experienced as a child, adolescent or young adult and can severely impact an individual's ability to engage in education and employment. What this article adds: Using the Integrated Data Infrastructure (IDI), a national collection of linked health and non-health data, we explored the characteristics of working-age adults with OCD who had accessed public secondary health services in Aotearoa | New Zealand (NZ).There were marked differences in the rates of OCD for geographic areas corresponding to the regional divisions of Health NZ | Te Whatu Ora, and, as previously described, by ethnicity. These findings suggest inequity of access to healthcare and merit further investigation.In comparison to other working-age adults, people in the study cohort were moderately less likely to have achieved higher level educational qualifications, and they were markedly less likely to be employed and to belong to a higher income bracket.Accessing public secondary health services is likely to be a proxy for more severe and/or complex psychological disability and many people in this cohort had other mental health and related conditions. Therefore, the characteristics of this cohort cannot be generalised to the entire group of people who experience OCD in NZ.