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Obsessive-compulsive disorder(OCD)

MedGen UID:
14445
Concept ID:
C0028768
Mental or Behavioral Dysfunction
Synonym: OCD
SNOMED CT: Obsessive compulsive disorder (191736004); Obsessive-compulsive disorder (191736004); OCD - obsessive-compulsive disorder (191736004)
 
Genes (locations): HTR2A (13q14.2); SLC6A4 (17q11.2)
 
Monarch Initiative: MONDO:0008114
OMIM®: 164230

Definition

Obsessive-compulsive disorder (OCD) is characterized by recurring obsessions and/or compulsions and has been estimated to affect nearly 5 million people in the United States (Karno et al., 1988). Evidence for a strong genetic component in OCD comes from twin studies, family genetics studies, and segregation analyses, as reviewed by Alsobrook et al. (2002). Zhang et al. (2002) suggested that hoarding is likely to be an evolutionarily conserved trait that, in times of adversity, was associated with increased survival and reproductive fitness. However, extreme forms of this trait are associated with marked disability and poor response to treatment (Black et al., 1998; Mataix-Cols et al., 1999). [from OMIM]

Additional description

From MedlinePlus Genetics
Obsessive-compulsive disorder (OCD) is a mental health condition characterized by features called obsessions and compulsions. Obsessions are intrusive thoughts, mental images, or urges to perform specific actions. While the particular obsessions vary widely, they often include fear of illness or contamination; a desire for symmetry or getting things "just right;" or intrusive thoughts involving religion, sex, or aggression. Compulsions consist of the repetitive performance of certain actions, such as checking or verifying, washing, counting, arranging, acting out specific routines, or seeking assurance. These behaviors are performed to relieve anxiety, rather than to seek pleasure as in other compulsive behaviors like gambling, eating, or sex.

While almost everyone experiences obsessive feelings and compulsive behaviors occasionally or in particular contexts, in OCD they take up more than an hour a day and cause problems with work, school, or social life. People with OCD generally experience anxiety and other distress around their need to accommodate their obsessions or compulsions.

About half the time, OCD becomes evident in childhood or adolescence, and most other cases appear in early adulthood. It is unusual for OCD to start after age 40. It tends to appear earlier in males, but by adulthood it is slightly more common in females. Affected individuals can experience periods when their symptoms increase or decrease in severity, but the condition usually does not go away completely.

Some people with OCD have additional mental health disorders such as generalized anxiety, depression, phobias, panic disorders, or schizophrenia. OCD can also occur in people with other neurological conditions such as Tourette syndrome and similar disorders, traumatic brain injury, stroke, or dementia.  https://medlineplus.gov/genetics/condition/obsessive-compulsive-disorder

Clinical features

From HPO
Anxiety
MedGen UID:
1613
Concept ID:
C0003467
Finding
Intense feelings of nervousness, tension, or panic often arise in response to interpersonal stresses. There is worry about the negative effects of past unpleasant experiences and future negative possibilities. Individuals may feel fearful, apprehensive, or threatened by uncertainty, and they may also have fears of falling apart or losing control.
Depression
MedGen UID:
4229
Concept ID:
C0011581
Mental or Behavioral Dysfunction
Frequently experiencing feelings of being down, miserable, and/or hopeless; struggling to recover from these moods; having a pessimistic outlook on the future; feeling a pervasive sense of shame; having a low self-worth; experiencing thoughts of suicide and engaging in suicidal behavior.
Collectionism
MedGen UID:
603043
Concept ID:
C0424290
Finding
Excessive or pathological tendency to save and collect possessions.
Compulsive behaviors
MedGen UID:
109373
Concept ID:
C0600104
Mental or Behavioral Dysfunction
Behavior that consists of repetitive acts, characterized by the feeling that one "has to" perform them, while being aware that these acts are not in line with one's overall goal.
Skin-picking
MedGen UID:
488979
Concept ID:
C1696701
Mental or Behavioral Dysfunction
Repetitive and compulsive picking of skin which results in tissue damage.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVObsessive-compulsive disorder

Professional guidelines

PubMed

Goodman WK, Storch EA, Sheth SA
Am J Psychiatry 2021 Jan 1;178(1):17-29. doi: 10.1176/appi.ajp.2020.20111601. PMID: 33384007Free PMC Article
Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M
Curr Neuropharmacol 2019;17(8):710-736. doi: 10.2174/1570159X16666180813155017. PMID: 30101713Free PMC Article
Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M; Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University, Antony MM, Bouchard S, Brunet A, Flament M, Grigoriadis S, Mendlowitz S, O'Connor K, Rabheru K, Richter PM, Robichaud M, Walker JR
BMC Psychiatry 2014;14 Suppl 1(Suppl 1):S1. Epub 2014 Jul 2 doi: 10.1186/1471-244X-14-S1-S1. PMID: 25081580Free PMC Article

Recent clinical studies

Etiology

Hudepohl N, MacLean JV, Osborne LM
Curr Psychiatry Rep 2022 Apr;24(4):229-237. Epub 2022 Apr 6 doi: 10.1007/s11920-022-01333-4. PMID: 35384553Free PMC Article
Mattina GF, Slyepchenko A, Steiner M
Handb Clin Neurol 2020;175:369-386. doi: 10.1016/B978-0-444-64123-6.00025-4. PMID: 33008538
Marazziti D, Mucci F, Fontenelle LF
Psychoneuroendocrinology 2018 Jul;93:39-44. Epub 2018 Apr 13 doi: 10.1016/j.psyneuen.2018.04.013. PMID: 29689421
Abramowitz JS, Taylor S, McKay D
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Zohar J, Hermesh H
Isr J Psychiatry Relat Sci 2008;45(3):149-50. PMID: 19398818

Diagnosis

Schuyler M, Geller DA
Psychiatr Clin North Am 2023 Mar;46(1):89-106. Epub 2022 Dec 26 doi: 10.1016/j.psc.2022.10.002. PMID: 36740357
Cervin M
Psychiatr Clin North Am 2023 Mar;46(1):1-16. Epub 2022 Dec 13 doi: 10.1016/j.psc.2022.10.006. PMID: 36740346
Pampaloni I, Marriott S, Pessina E, Fisher C, Govender A, Mohamed H, Chandler A, Tyagi H, Morris L, Pallanti S
Compr Psychiatry 2022 Oct;118:152342. Epub 2022 Aug 6 doi: 10.1016/j.comppsych.2022.152342. PMID: 36007341
Krebs G, Heyman I
Arch Dis Child 2015 May;100(5):495-9. Epub 2014 Nov 14 doi: 10.1136/archdischild-2014-306934. PMID: 25398447Free PMC Article
Goodman WK, Grice DE, Lapidus KA, Coffey BJ
Psychiatr Clin North Am 2014 Sep;37(3):257-67. Epub 2014 Jul 23 doi: 10.1016/j.psc.2014.06.004. PMID: 25150561

Therapy

Carpenter JK, Andrews LA, Witcraft SM, Powers MB, Smits JAJ, Hofmann SG
Depress Anxiety 2018 Jun;35(6):502-514. Epub 2018 Feb 16 doi: 10.1002/da.22728. PMID: 29451967Free PMC Article
Hirschtritt ME, Bloch MH, Mathews CA
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Jayakody K, Gunadasa S, Hosker C
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Prognosis

Marsden Z, Lovell K, Blore D, Ali S, Delgadillo J
Clin Psychol Psychother 2018 Jan;25(1):e10-e18. Epub 2017 Jul 28 doi: 10.1002/cpp.2120. PMID: 28752580
Speisman BB, Storch EA, Abramowitz JS
J Obstet Gynecol Neonatal Nurs 2011 Nov-Dec;40(6):680-90. Epub 2011 Nov 3 doi: 10.1111/j.1552-6909.2011.01294.x. PMID: 22092284
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Mundt JC, Marks IM, Shear MK, Greist JH
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Warnock JK, Kestenbaum T
Dermatol Clin 1996 Jul;14(3):465-72. doi: 10.1016/s0733-8635(05)70374-0. PMID: 8818556

Clinical prediction guides

Martinho FP, Magalhães D, Felício R, Ferreira TF, Jorge S
Schizophr Res 2023 May;255:41-51. Epub 2023 Mar 21 doi: 10.1016/j.schres.2023.03.024. PMID: 36958269
Tonna M, Trinchieri M, Lucarini V, Ferrari M, Ballerini M, Ossola P, De Panfilis C, Marchesi C
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Rough HE, Hanna BS, Gillett CB, Rosenberg DR, Gehring WJ, Arnold PD, Hanna GL
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Anton RF
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Recent systematic reviews

Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N
Clin Psychol Rev 2022 Dec;98:102213. Epub 2022 Oct 30 doi: 10.1016/j.cpr.2022.102213. PMID: 36356351
Marincowitz C, Lochner C, Stein DJ
CNS Spectr 2022 Dec;27(6):664-675. Epub 2021 Aug 11 doi: 10.1017/S1092852921000754. PMID: 34378500
Nikolova VL, Smith MRB, Hall LJ, Cleare AJ, Stone JM, Young AH
JAMA Psychiatry 2021 Dec 1;78(12):1343-1354. doi: 10.1001/jamapsychiatry.2021.2573. PMID: 34524405Free PMC Article
Rapinesi C, Kotzalidis GD, Ferracuti S, Sani G, Girardi P, Del Casale A
Curr Neuropharmacol 2019;17(8):787-807. doi: 10.2174/1570159X17666190409142555. PMID: 30963971Free PMC Article
Sigra S, Hesselmark E, Bejerot S
Neurosci Biobehav Rev 2018 Mar;86:51-65. Epub 2018 Jan 6 doi: 10.1016/j.neubiorev.2018.01.001. PMID: 29309797

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