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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 neurosis (191736004); Anancastic neurosis (191736004); Anankastic neurosis (191736004); OCD - Obsessive-compulsive disorder (191736004); 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, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.
Depression
MedGen UID:
4229
Concept ID:
C0011581
Mental or Behavioral Dysfunction
Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame; feeling of inferior self-worth; thoughts of suicide and 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
Recurrent obsessions or compulsions that are severe enough to be time consuming (i.e., they take more than 1 hour a day) or cause marked distress or significant impairment (DSM-IV).
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
Pittenger C, Bloch MH
Psychiatr Clin North Am 2014 Sep;37(3):375-91. Epub 2014 Jul 24 doi: 10.1016/j.psc.2014.05.006. PMID: 25150568Free 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
Cooper SE, Dunsmoor JE
Neurosci Biobehav Rev 2021 Oct;129:75-94. Epub 2021 Jul 24 doi: 10.1016/j.neubiorev.2021.07.026. PMID: 34314751Free PMC Article
Citkowska-Kisielewska A, Rutkowski K, Sobański JA, Dembińska E, Mielimąka M
Psychiatr Pol 2019 Aug 31;53(4):845-864. doi: 10.12740/PP/105378. PMID: 31760413
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
Zohar J, Hermesh H
Isr J Psychiatry Relat Sci 2008;45(3):149-50. PMID: 19398818

Diagnosis

Drubach DA
Continuum (Minneap Minn) 2015 Jun;21(3 Behavioral Neurology and Neuropsychiatry):783-8. doi: 10.1212/01.CON.0000466666.12779.07. PMID: 26039854
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
Veale D, Roberts A
BMJ 2014 Apr 7;348:g2183. doi: 10.1136/bmj.g2183. PMID: 24709802
Bokor G, Anderson PD
J Pharm Pract 2014 Apr;27(2):116-30. Epub 2014 Feb 27 doi: 10.1177/0897190014521996. PMID: 24576790

Therapy

Andrade C
J Clin Psychiatry 2019 Dec 3;80(6) doi: 10.4088/JCP.19f13163. PMID: 31846244
Lee DJ, Lozano CS, Dallapiazza RF, Lozano AM
J Neurosurg 2019 Aug 1;131(2):333-342. doi: 10.3171/2019.4.JNS181761. PMID: 31370011
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
JAMA 2017 Apr 4;317(13):1358-1367. doi: 10.1001/jama.2017.2200. PMID: 28384832
Deepmala, Slattery J, Kumar N, Delhey L, Berk M, Dean O, Spielholz C, Frye R
Neurosci Biobehav Rev 2015 Aug;55:294-321. Epub 2015 May 6 doi: 10.1016/j.neubiorev.2015.04.015. PMID: 25957927

Prognosis

Külz AK, Landmann S, Cludius B, Rose N, Heidenreich T, Jelinek L, Alsleben H, Wahl K, Philipsen A, Voderholzer U, Maier JG, Moritz S
Eur Arch Psychiatry Clin Neurosci 2019 Mar;269(2):223-233. Epub 2018 Nov 16 doi: 10.1007/s00406-018-0957-4. PMID: 30446822
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
Ruscio AM, Stein DJ, Chiu WT, Kessler RC
Mol Psychiatry 2010 Jan;15(1):53-63. Epub 2008 Aug 26 doi: 10.1038/mp.2008.94. PMID: 18725912Free PMC Article
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
Proietti L, Aguglia A, Amerio A, Costanza A, Fesce F, Magnani L, Serafini G, Amore M
Acta Biomed 2022 Sep 22;93(S1):e2022271. doi: 10.23750/abm.v93iS1.13064. PMID: 36134720Free PMC Article
Hageman SB, van Rooijen G, Bergfeld IO, Schirmbeck F, de Koning P, Schuurman PR, Denys D
Acta Psychiatr Scand 2021 Apr;143(4):307-318. Epub 2021 Feb 11 doi: 10.1111/acps.13276. PMID: 33492682
Mersin Kilic S, Dondu A, Memis CO, Ozdemiroglu F, Sevincok L
J Atten Disord 2020 Oct;24(12):1757-1763. Epub 2016 Sep 21 doi: 10.1177/1087054716669226. PMID: 27655144
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS
Arch Gen Psychiatry 1989 Nov;46(11):1006-11. doi: 10.1001/archpsyc.1989.01810110048007. PMID: 2684084

Recent systematic reviews

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
Deepmala, Slattery J, Kumar N, Delhey L, Berk M, Dean O, Spielholz C, Frye R
Neurosci Biobehav Rev 2015 Aug;55:294-321. Epub 2015 May 6 doi: 10.1016/j.neubiorev.2015.04.015. PMID: 25957927

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