OBSESSIVE COMPULSIVE DISORDER - A REVIEW OF TREATMENT METHODS
DOI:
https://doi.org/10.31435/ijitss.3(47).2025.3714Keywords:
Obsessive-Compulsive Disorder, Selective Serotonin Reuptake Inhibitor, Cognitive Behavioral Therapy, Exposure and Response Prevention TherapyAbstract
Obsessive Compulsive Disorder (OCD) is a neuropsychiatric disorder characterized by the presence of recurring intrusive thoughts (obsessions) and compulsive actions (compulsions).
In the United States of America the prevalence of lifetime OCD in adult patients is estimated to be around 2,3% of the population, while 12-month OCD cases stand at 1,2%. Diagnostic criteria include:
- Presence of obsessions, compulsions or both
- Obsessions or compulsions are time-consuming or cause a lot of distress, or impair other aspects of life
- The symptoms are not caused by substance abuse or another medical condition
- The disorder is not better explained by symptoms of another mental disorder
Zohar-Fineberg Obsessive Compulsive Screen is a questionnaire which helps with assessment of OCD. Main lines of treatment consist of pharmacotherapy and psychotherapy. Pharmacotherapy relies primarily on selective serotonin reuptake inhibitors, while other medications include serotonin-noradrenaline reuptake inhibitors, clomipramine, neuroleptics and glutamate modifiers. Psychosurgery and neurostimulation both invasive and non-invasive, is reserved for treatment-resistant cases of OCD.
References
Pampaloni I, Marriott S, Pessina E, Fisher C, Govender A, Mohamed H, Chandler A, Tyagi H, Morris L, Pallanti S. The global assessment of OCD. Compr Psychiatry. 2022 Oct;118:152342. doi: 10.1016/j.comppsych.2022.152342. Epub 2022 Aug 6. Erratum in: Compr Psychiatry. 2024 Nov;135:152518. doi: 10.1016/j.comppsych.2024.152518. PMID: 36007341.
Singh A, Anjankar VP, Sapkale B. Obsessive-Compulsive Disorder (OCD): A Comprehensive Review of Diagnosis, Comorbidities, and Treatment Approaches. Cureus. 2023 Nov 17;15(11):e48960. doi: 10.7759/cureus.48960. PMID: 38111433; PMCID: PMC10726089.
Stein DJ, Costa DLC, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG, van den Heuvel OA, Simpson HB. Obsessive-compulsive disorder. Nat Rev Dis Primers. 2019 Aug 1;5(1):52. doi: 10.1038/s41572-019-0102-3. Erratum in: Nat Rev Dis Primers. 2024 Oct 16;10(1):79. doi: 10.1038/s41572-024-00569-z. PMID: 31371720; PMCID: PMC7370844.
Kühne F, Paunov T, Weck F. Recognizing obsessive-compulsive disorder: how suitable is the German Zohar-Fineberg obsessive-compulsive screen? BMC Psychiatry. 2021 Sep 11;21(1):450. doi: 10.1186/s12888-021-03458-x. Erratum in: BMC Psychiatry. 2022 Jan 21;22(1):50. doi: 10.1186/s12888-022-03692-x. PMID: 34511062; PMCID: PMC8436546.
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989 Nov;46(11):1006-11. doi: 10.1001/archpsyc.1989.01810110048007. PMID: 2684084.
Weingarden H, Renshaw KD. Shame in the obsessive compulsive related disorders: a conceptual review. J Affect Disord. 2015 Jan 15;171:74-84. doi: 10.1016/j.jad.2014.09.010. Epub 2014 Sep 20. PMID: 25299438; PMCID: PMC4252512.
Mataix-Cols D, Rauch SL, Manzo PA, Jenike MA, Baer L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999 Sep;156(9):1409-16. doi: 10.1176/ajp.156.9.1409. PMID: 10484953.
Menchón JM, van Ameringen M, Dell'Osso B, Denys D, Figee M, Grant JE, Hollander E, Marazziti D, Nicolini H, Pallanti S, Ruck C, Shavitt R, Stein DJ, Andersson E, Bipeta R, Cath DC, Drummond L, Feusner J, Geller DA, Hranov G, Lochner C, Matsunaga H, McCabe RE, Mpavaenda D, Nakamae T, O'Kearney R, Pasquini M, Pérez Rivera R, Poyurovsky M, Real E, do Rosário MC, Soreni N, Swinson RP, Vulink N, Zohar J, Fineberg N. Standards of care for obsessive-compulsive disorder centres. Int J Psychiatry Clin Pract. 2016 Sep;20(3):204-8. doi: 10.1080/13651501.2016.1197275. PMID: 27359333; PMCID: PMC4950405.
Phillips KA, Hart AS, Menard W, Eisen JL. Psychometric evaluation of the Brown Assessment of Beliefs Scale in body dysmorphic disorder. J Nerv Ment Dis. 2013 Jul;201(7):640-3. doi: 10.1097/NMD.0b013e3182983041. PMID: 23817164; PMCID: PMC3725596.
Lebowitz ER, Panza KE, Bloch MH. Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update. Expert Rev Neurother. 2016;16(1):45-53. doi: 10.1586/14737175.2016.1126181. Epub 2015 Dec 22. PMID: 26613396; PMCID: PMC4895189.
Pallanti S, Quercioli L. Treatment-refractory obsessive-compulsive disorder: methodological issues, operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006 May;30(3):400-12. doi: 10.1016/j.pnpbp.2005.11.028. Epub 2006 Feb 28. PMID: 16503369.
Ravizza L, Barzega G, Bellino S, Bogetto F, Maina G. Predictors of drug treatment response in obsessive-compulsive disorder. J Clin Psychiatry. 1995 Aug;56(8):368-73. PMID: 7635854.
Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010 Jan;15(1):53-63. doi: 10.1038/mp.2008.94. Epub 2008 Aug 26. PMID: 18725912; PMCID: PMC2797569.
Brock H, Rizvi A, Hany M. Obsessive-Compulsive Disorder. 2024 Feb 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 31985955.
Maraone A, Tarsitani L, Pinucci I, Pasquini M. Antiglutamatergic agents for obsessive-compulsive disorder: Where are we now and what are possible future prospects? World J Psychiatry. 2021 Sep 19;11(9):568-580. doi: 10.5498/wjp.v11.i9.568. PMID: 34631461; PMCID: PMC8474998.
Goodman WK, Storch EA, Sheth SA. Harmonizing the Neurobiology and Treatment of Obsessive-Compulsive Disorder. Am J Psychiatry. 2021 Jan 1;178(1):17-29. doi: 10.1176/appi.ajp.2020.20111601. PMID: 33384007; PMCID: PMC8091795.
Bird JS, Shah E, Shotbolt P. Epilepsy and concomitant obsessive-compulsive disorder. Epilepsy Behav Case Rep. 2018 Jul 20;10:106-110. doi: 10.1016/j.ebcr.2018.07.001. PMID: 30271707; PMCID: PMC6158956.
Parmar A, Verma R. A Case of Obsessive-Compulsive Disorder Comorbid with Miyoshi Myopathy. Indian J Psychol Med. 2018 Jan-Feb;40(1):86-88. doi: 10.4103/IJPSYM.IJPSYM_1_17. PMID: 29403136; PMCID: PMC5795685.
Murphy TK, Patel PD, McGuire JF, Kennel A, Mutch PJ, Parker-Athill EC, Hanks CE, Lewin AB, Storch EA, Toufexis MD, Dadlani GH, Rodriguez CA. Characterization of the pediatric acute-onset neuropsychiatric syndrome phenotype. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):14-25. doi: 10.1089/cap.2014.0062. Epub 2014 Oct 14. PMID: 25314221; PMCID: PMC4340632.
Jalal B, Chamberlain SR, Sahakian BJ. Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction. Brain Behav. 2023 Jun;13(6):e3000. doi: 10.1002/brb3.3000. Epub 2023 May 3. PMID: 37137502; PMCID: PMC10275553.
Krzyszkowiak W, Kuleta-Krzyszkowiak M, Krzanowska E. Treatment of obsessive-compulsive disorders (OCD) and obsessive-compulsive-related disorders (OCRD). Psychiatr Pol. 2019 Aug 31;53(4):825-843. English, Polish. doi: 10.12740/PP/105130. Epub 2019 Aug 31. PMID: 31760412.
Elsouri KN, Heiser SE, Cabrera D, Alqurneh S, Hawat J, Demory ML. Management and Treatment of Obsessive-Compulsive Disorder (OCD): A Literature Review. Cureus. 2024 May 17;16(5):e60496. doi: 10.7759/cureus.60496. PMID: 38883111; PMCID: PMC11180522.
Kvale G, Hansen B, Björgvinsson T, Børtveit T, Hagen K, Haseth S, Kristensen UB, Launes G, Ressler KJ, Solem S, Strand A, van den Heuvel OA, Öst LG. Successfully treating 90 patients with obsessive compulsive disorder in eight days: the Bergen 4-day treatment. BMC Psychiatry. 2018 Oct 4;18(1):323. doi: 10.1186/s12888-018-1887-4. PMID: 30286745; PMCID: PMC6172736.
Pediatric OCD Treatment Study (POTS) Team. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004 Oct 27;292(16):1969-76. doi: 10.1001/jama.292.16.1969. PMID: 15507582.
Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. Psychiatr Clin North Am. 2014 Sep;37(3):375-91. doi: 10.1016/j.psc.2014.05.006. Epub 2014 Jul 24. PMID: 25150568; PMCID: PMC4143776.
Starcevic V, Brakoulias V. Symptom subtypes of obsessive-compulsive disorder: are they relevant for treatment? Aust N Z J Psychiatry. 2008 Aug;42(8):651-61. doi: 10.1080/00048670802203442. PMID: 18622773.
van Roessel PJ, Grassi G, Aboujaoude EN, Menchón JM, Van Ameringen M, Rodríguez CI. Treatment-resistant OCD: Pharmacotherapies in adults. Compr Psychiatry. 2023 Jan;120:152352. doi: 10.1016/j.comppsych.2022.152352. Epub 2022 Oct 25. PMID: 36368186.
Kammen A, Cavaleri J, Lam J, Frank AC, Mason X, Choi W, Penn M, Brasfield K, Van Noppen B, Murray SB, Lee DJ. Neuromodulation of OCD: A review of invasive and non-invasive methods. Front Neurol. 2022 Aug 9;13:909264. doi: 10.3389/fneur.2022.909264. PMID: 36016538; PMCID: PMC9397524.
Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, Filipović SR, Grefkes C, Hasan A, Hummel FC, Jääskeläinen SK, Langguth B, Leocani L, Londero A, Nardone R, Nguyen JP, Nyffeler T, Oliveira-Maia AJ, Oliviero A, Padberg F, Palm U, Paulus W, Poulet E, Quartarone A, Rachid F, Rektorová I, Rossi S, Sahlsten H, Schecklmann M, Szekely D, Ziemann U. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol. 2020 Feb;131(2):474-528. doi: 10.1016/j.clinph.2019.11.002. Epub 2020 Jan 1. Erratum in: Clin Neurophysiol. 2020 May;131(5):1168-1169. doi: 10.1016/j.clinph.2020.02.003. PMID: 31901449.
Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry. 2004 Jun;61(6):564-76. doi: 10.1001/archpsyc.61.6.564. PMID: 15184236.
Hamani C, Pilitsis J, Rughani AI, Rosenow JM, Patil PG, Slavin KS, Abosch A, Eskandar E, Mitchell LS, Kalkanis S; American Society for Stereotactic and Functional Neurosurgery; Congress of Neurological Surgeons; CNS and American Association of Neurological Surgeons. Deep brain stimulation for obsessive-compulsive disorder: systematic review and evidence-based guideline sponsored by the American Society for Stereotactic and Functional Neurosurgery and the Congress of Neurological Surgeons (CNS) and endorsed by the CNS and American Association of Neurological Surgeons. Neurosurgery. 2014 Oct;75(4):327-33; quiz 333. doi: 10.1227/NEU.0000000000000499. PMID: 25050579.
Staudt MD, Pouratian N, Miller JP, Hamani C, Raviv N, McKhann GM, Gonzalez-Martinez JA, Pilitsis JG. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Deep Brain Stimulations for Obsessive-Compulsive Disorder: Update of the 2014 Guidelines. Neurosurgery. 2021 Mar 15;88(4):710-712. doi: 10.1093/neuros/nyaa596. PMID: 33559678; PMCID: PMC8133323.
Wu H, Hariz M, Visser-Vandewalle V, Zrinzo L, Coenen VA, Sheth SA, Bervoets C, Naesström M, Blomstedt P, Coyne T, Hamani C, Slavin K, Krauss JK, Kahl KG, Taira T, Zhang C, Sun B, Toda H, Schlaepfer T, Chang JW, Régis J, Schuurman R, Schulder M, Doshi P, Mosley P, Poologaindran A, Lázaro-Muñoz G, Pepper J, Schechtmann G, Fytagoridis A, Huys D, Gonçalves-Ferreira A, D'Haese PF, Neimat J, Broggi G, Vilela-Filho O, Voges J, Alkhani A, Nakajima T, Richieri R, Djurfeldt D, Fontaine P, Martinez-Alvarez R, Okamura Y, Chandler J, Watanabe K, Barcia JA, Reneses B, Lozano A, Gabriëls L, De Salles A, Halpern CH, Matthews K, Fins JJ, Nuttin B. Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established therapy? Mol Psychiatry. 2021 Jan;26(1):60-65. doi: 10.1038/s41380-020-00933-x. Epub 2020 Nov 3. PMID: 33144712; PMCID: PMC7815503.
Downloads
Published
Issue
Section
License
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

