7 OCD

Obsessions

Recurrent, persistent, intrusive, and unwanted thoughts, urges, or images that cause marked anxiety or distress.

Compulsions

Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or rigid rules to reduce anxiety.

Diagnostic Time Requirement for OCD

Obsessions or compulsions must be time-consuming, taking more than one hour per day, or cause clinically significant impairment in functioning.

Good or Fair Insight Specifier

An OCD specifier applied when the individual recognizes that their disorder beliefs are definitely or probably not true.

Poor Insight Specifier

An OCD specifier applied when the individual thinks their disorder beliefs are probably true.

Absent Insight or Delusional Beliefs Specifier

An OCD specifier applied when the individual is completely convinced that their disorder beliefs are true.

Tic-Related Specifier

An OCD specifier applied when the individual has a current or past history of a tic disorder.

Contamination Symptoms

An OCD dimension involving concerns about dirt or germs that leads to washing, showering, or cleaning compulsions.

Harm-Related Symptoms

An OCD dimension involving persistent concerns about causing harm that leads to checking compulsions.

Symmetry Symptoms

An OCD dimension involving precision concerns that leads to ordering, straightening, repeating, or counting compulsions.

Yale-Brown Obsessive Compulsive Scale

A rating scale evaluating OCD severity on an ordinal scale from 0 to 4 based on time spent, interference, distress, resistance, and degree of control.

CSTC Circuits

Parallel corticostriato-thalamo-cortical brain circuits involved in sensorimotor, cognitive, affective, and motivational processes that mediate OCD.

Sensorimotor CSTC Circuit

A brain circuit underlying stimulus-response-based habitual behavior that is implicated in the later phase of OCD.

Frontolimbic Circuit

A brain circuit involved in fear extinction that is implicated in the early phase of OCD.

Heritability of OCD

Additive genetic effects account for approximately 40% of the variance in OCD, with higher heritability observed in early-onset cases with tics.

Glutamate and Dopamine

Neurotransmitters within the CSTC circuits that play a key role in underpinning OCD symptoms and stereotypic behaviors.

Exposure with Response Prevention

A key cognitive-behavioral therapy component for OCD where patients are exposed to feared stimuli while refraining from performing compulsive rituals.

Prognosis with Serotonergic Medications

Treatment with serotonergic medications reduces OCD symptoms by 30% to 50% in 60% to 80% of individuals.