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To Your Good Health: Obsessive-Compulsive Disorder Can Be Challenging To Diagnose

Dear Dr. Roach: What can you tell me about obsessive-compulsive disorder? My 60-year-old brother recently was diagnosed with such, but he won’t discuss it. — K.K.

Answer: Obsessive-compulsive disorder is one of the most under-diagnosed psychiatric conditions. The average time from development of symptoms to diagnosis is seven years!

When the syndrome is full-blown and classic, it is easy to spot, but many people have lesser degrees of symptoms. OCD is diagnosed when people report unwanted, repeated thoughts (obsessions) and/or behaviors that the person needs to do in order to make the thoughts go away (compulsions). It is usually present by the age of 30, so I wonder how long your brother may have suffered before being diagnosed.

Some classic behaviors include hand-washing, checking to be sure the door is locked and excessive counting. Most people have periods of severe symptoms followed by longer periods of no or mild symptoms. Since the hardest part of treatment often is recognizing the condition, it is important for a person to bring it up with his or her doctor.

There is effective treatment, both with and without medications. General doctors may treat this condition, or may refer a patient to a specialist in the field, a psychiatrist. If you are frequently experiencing unwanted thoughts or feelings, or have repeated behaviors that interfere with daily life or relationships, it’s worthwhile to discuss it with your doctor, and not to be embarrassed about it.

Dear Dr. Roach: I have read recently some confusing advice regarding daily multivitamins. Are they good or bad for you? — G.M.

Answer: Two studies have recently come out suggesting that vitamins do not have a health benefit. One study, recently published, followed two groups of men, some taking and some not taking vitamins, for 10 years. It showed no reduction in heart disease risk, but it did show a small reduction in cancer risk.

Another, done with women, actually suggested a small increase in risk for those taking a multivitamin, although vitamin D did show some benefit.

Experts remain divided on the subject, with those on one side pointing out that many of us don’t get the proper amount of nutrients in our diet, especially if we don’t eat enough fresh fruits and vegetables. On the other side, some experts worry that taking a vitamin can make you complacent about eating properly or otherwise taking good care of yourself. Because the data is mixed, I personally don’t recommend vitamins to people who aren’t taking them, but I don’t try to stop people who do take a regular vitamin. I do look carefully at the ingredients in the vitamins people are taking to make sure there is not excessive vitamin A (greater than 10,000 IU is too much), especially in women who might get pregnant. Taking very large doses of vitamins can cause symptoms, and stopping them suddenly can lead to symptoms of vitamin deficiency.

Regardless of whether you take a multivitamin, it is still important to get in your five servings a day of fruits and vegetables. Vitamins aren’t an excuse for unhealthy living.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.