Abstract

Obsessive-compulsive and related disorders (OCRDs) now have their own category in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Disorders currently classified as OCRDs are obsessive-compulsive disorder, trichotillomania (hair pulling disorder), excoriation (skin picking) disorder, hoarding disorder, and body dysmorphic disorder. Collectively, the OCRDs are prevalent, cause considerable functional impairment, and are often overlooked by clinicians. This review surveys current definitions and diagnosis of OCRDs, highlighting recommended assessment tools, differential diagnoses, and medical issues. The heritability of OCRDs is examined, based on available twin data, along with implicated genetic factors. Neurobiological understanding of OCRDs is outlined, focusing on dysregulation of habit generation and top-down response control corticostriatal pathways. The review then highlights evidence-based treatments for OCRDs, which differ considerably between individual disorders. Treatment guidance includes descriptions of target medication doses and therapy content. Lastly, limitations in the current knowledge base for OCRDs are reviewed, with implications for future research directions. This review contains 1 figure, 7 tables, and 40 references. Key words: compulsivity, dopamine, glutamate, impulsivity, screening for OCD, serotonin

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