Una Enfermadad Real: OCD and Health Disparities at the U.S.- Mexico Border

Authors: Tom Olson, PhD, APRN, BC; Oriana Perez, BA; Karla Horton, BA

Background:
Obsessive-compulsive disorder (OCD) is ranked by the World Health Organization as one of the ten leading causes of disability worldwide for persons over age five. Yet there is a dearth of information on the relationship between culture, ethnicity and OCD. The objective of this research was to describe, examine and explore issues involving the cultural identification, symptoms, health concerns, coping mechanisms, and quality of life of persons with OCD in a population at high risk for health disparities, Mexican-origin persons living in the U.S.Mexico border region of El Paso, Texas and Ciudad Juarez, Mexico.

Method:
A mixed methods, descriptive approach was used for understanding the multiple factors affecting OCD and health disparities among a purposive sample of 85 Mexican-origin adults. Four research instruments, validated for English- and Spanish-speaking persons, provided qualitative and quantitative data to address the research objective. These included a demographic tool and brief acculturation measure; a symptom severity tool; a quality of life measure; and a semi-structured interview.

Results:
Participants’ symptoms ranged from moderate to extreme, resulting in marked impairment in quality of life (p<0.05), particularly in terms of social functioning, an area of central importance for many Mexican-origin person. At the time of interview, only 26.9% of the participants were receiving one of the several medications shown to be effective in treating OCD. Only one participant was involved in exposure response prevention therapy (ERP), a highly effective, evidence-based treatment for this condition.

Conclusions:
This research emphasized both the seriousness of OCD along the border and the marked health disparities, in terms of access to and availability of evidence-based treatments. It has also laid the groundwork for the study of a community-based, cost-effective, nurse-led intervention to decrease health disparities for Mexican-origin persons with OCD and their families living in the border region

* Funded by grants from the Hispanic Health Disparities Center, University of Texas at El Paso (NIH, P20 MD000548-01) and the National Institute of Nursing Research (NIH R03 NR009974-01).