Obsessive-Compulsive Disorder: Diagnosis, Epidemiology, Etiology, and Treatment

Abstract

Obsessive-compulsive disorder (OCD) has been given increased attention in DSM-5, receiving its own chapter. In this article, the authors discuss changes to the diagnostic criteria and symptoms differentiating OCD from other disorders. Two new specifiers, which have relevance in regard to treatment selection, appear in DSM-5: level of insight and presence of tic disorder. The epidemiology of OCD remains under investigation and may be modified based on the new DSM-5 criteria. Current data regarding age of onset and social and occupational functioning of patients with OCD are presented. The structural and functional neuroanatomy of OCD has been an area of increased research attention, and the authors summarize the research in this area. Treatment of OCD remains difficult, involving a combination of pharmacotherapy and cognitive-behavorial therapy, with a large percentage of nonresponders to initial treatment. The authors review pharmacotherapy recommendations from the APA practice guidelines and discuss evid...