[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"condition-ocd":3},{"id":4,"title":5,"abbr":6,"assessments":7,"bgClass":29,"body":30,"category":6,"comorbidities":37,"description":67,"dsmCriteria":68,"etiology":91,"extension":127,"heroSubtitle":128,"heroTitle":129,"icdCode":130,"icon":131,"iconClass":132,"labelClass":6,"lastReviewed":6,"meta":133,"name":156,"navigation":157,"onsetAge":158,"path":159,"prevalence":160,"ratio":161,"responseRate":162,"seo":163,"slug":164,"sources":165,"stem":188,"takeaways":6,"tools":6,"treatments":189,"__hash__":221},"conditions\u002Fconditions\u002Focd.md","OCD Clinical Guide: Y-BOCS, ERP and DSM-5-TR Criteria",null,[8,15,22],{"name":9,"fullName":10,"description":11,"scoring":12,"timeframe":13,"icon":14},"Y-BOCS","Yale-Brown Obsessive Compulsive Scale","Criterion-standard severity measure. 10 items assessing obsessions and compulsions.","0-7: Subclinical | 8-15: Mild | 16-23: Moderate | 24-31: Severe | 32-40: Extreme","15-20 minutes","ph:clipboard-text",{"name":16,"fullName":17,"description":18,"scoring":19,"timeframe":20,"icon":21},"OCI-R","Obsessive-Compulsive Inventory-Revised","Brief 18-item self-report covering 6 OCD symptom dimensions.","Cut-off score: 21+ suggests clinically significant OCD symptoms","5-10 minutes","ph:check-square",{"name":23,"fullName":24,"description":25,"scoring":26,"timeframe":27,"icon":28},"DOCS","Dimensional Obsessive-Compulsive Scale","Assesses 4 primary OCD dimensions: contamination, responsibility, symmetry, taboo thoughts.","Provides subscale scores for different OCD presentations","10-15 minutes","ph:rows","bg-teal-500\u002F10",{"type":31,"value":32,"toc":33},"minimark",[],{"title":34,"searchDepth":35,"depth":35,"links":36},"",2,[],[38,43,48,53,58,62],{"condition":39,"prevalence":40,"note":41,"icon":42},"Major Depressive Disorder","25-50%","Often secondary to functional impairment from OCD symptoms","ph:cloud-rain",{"condition":44,"prevalence":45,"note":46,"icon":47},"Generalized Anxiety Disorder","20-30%","Overlapping worry patterns","ph:warning-circle",{"condition":49,"prevalence":50,"note":51,"icon":52},"Social Anxiety Disorder","11-25%","Especially with contamination or symmetry concerns in public","ph:users",{"condition":54,"prevalence":55,"note":56,"icon":57},"Body Dysmorphic Disorder","8-37%","Both involve obsessive focus and compulsive checking","ph:arrows-left-right",{"condition":59,"prevalence":45,"note":60,"icon":61},"Tic Disorders","Higher in childhood-onset OCD","ph:pulse",{"condition":63,"prevalence":64,"note":65,"icon":66},"ADHD","10-25%","Can complicate ERP due to attention deficits","ph:lightning","Detailed clinical guide to OCD: assessment protocols (Y-BOCS), diagnostic criteria, causes, comorbidities, and evidence-based treatment including ERP.",[69,76,83],{"title":70,"subtitle":71,"icon":72,"items":73},"Obsessions","Intrusive and unwanted thoughts","ph:brain",[74,75],"Recurrent, persistent thoughts, urges, or images experienced as intrusive and unwanted","Person attempts to ignore, suppress, or neutralize with another thought or action",{"title":77,"subtitle":78,"icon":79,"items":80},"Compulsions","Repetitive behaviors or mental acts","ph:repeat",[81,82],"Repetitive behaviors or mental acts performed in response to obsessions","Aimed at preventing or reducing distress, but not connected realistically or clearly excessive",{"title":84,"subtitle":85,"icon":86,"items":87},"Additional Criteria","Diagnostic requirements:","ph:warning",[88,89,90],"Obsessions\u002Fcompulsions are time-consuming (>1 hour\u002Fday) or cause significant distress","Not attributable to substance use or medical condition","Not better explained by another mental disorder",[92,100,109,118],{"category":93,"factors":94,"icon":72,"color":99},"Neurobiological",[95,96,97,98],"CSTC circuit dysfunction","Serotonin dysregulation","Elevated activity in orbitofrontal cortex and anterior cingulate","Reduced caudate nucleus volume in some studies","primary",{"category":101,"factors":102,"icon":107,"color":108},"Genetic",[103,104,105,106],"Heritability: 45-65%","Polygenic inheritance","SLC1A1, DLGAP3, BTBD3 genes implicated","10x increased risk with first-degree relative","ph:dna","secondary",{"category":110,"factors":111,"icon":116,"color":117},"Environmental",[112,113,114,115],"Childhood trauma","PANDAS\u002FPANS","Stressful life events","Parental accommodation","ph:globe","accent",{"category":119,"factors":120,"icon":125,"color":126},"Cognitive",[121,122,123,124],"Inflated sense of responsibility","Thought-action fusion","Intolerance of uncertainty","Overestimation of threat","ph:lightbulb","info","md","A chronic condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce distress.","Obsessive-Compulsive \u003Cbr \u002F> \u003Cspan class='text-gradient-flow'>Disorder (OCD)\u003C\u002Fspan>","F42.2","ph:arrows-clockwise","text-teal-500",{"faqs":134},[135,138,141,144,147,150,153],{"question":136,"answer":137},"What is Obsessive-Compulsive Disorder?","Obsessive-Compulsive Disorder (OCD) is a mental health condition defined in DSM-5-TR (ICD-11 code F42.2) by the presence of obsessions, compulsions, or both, that are time-consuming (more than 1 hour per day) or cause clinically significant distress or functional impairment. Obsessions are recurrent unwanted intrusive thoughts, urges, or images; compulsions are repetitive behaviors or mental acts the person performs in response to an obsession or according to rigid rules. OCD is no longer classified as an anxiety disorder in DSM-5-TR; it has its own chapter.",{"question":139,"answer":140},"What are the symptoms of OCD?","Common obsessions include contamination fears, fears of harm to self or others, intrusive sexual or violent thoughts, scrupulosity (religious or moral concerns), and need for symmetry or exactness. Common compulsions include excessive washing or cleaning, checking, counting, ordering or arranging, repeating actions, and seeking reassurance. The person typically recognizes the obsessions and compulsions as excessive or unreasonable, but cannot easily resist them. Avoidance of triggering situations is common.",{"question":142,"answer":143},"How is OCD diagnosed?","Diagnosis is made by a clinician using DSM-5-TR criteria, supported by structured assessment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the criterion-standard severity measure, used in nearly all OCD research. The Obsessive-Compulsive Inventory-Revised (OCI-R) is a validated 18-item self-report screener. A full clinical evaluation distinguishes OCD from related disorders (body dysmorphic disorder, hoarding disorder, trichotillomania), generalized anxiety disorder, and intrusive thoughts that are part of normal experience without clinical impairment.",{"question":145,"answer":146},"What causes OCD?","OCD has substantial genetic heritability, estimated at 40 to 65 percent. Multiple genes contribute, with strong evidence for serotonin and glutamate system involvement. Neurobiologically, OCD reflects dysfunction in the cortico-striato-thalamo-cortical (CSTC) circuit, particularly involving the orbitofrontal cortex, anterior cingulate cortex, and basal ganglia. Environmental contributors include childhood adversity, perinatal complications, and in rare cases pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Cognitive factors include inflated responsibility beliefs and intolerance of uncertainty.",{"question":148,"answer":149},"How is OCD treated?","First-line treatment is Exposure and Response Prevention (ERP), a specific form of CBT in which the patient gradually approaches feared situations or thoughts without performing the compulsion. ERP produces 60 to 70 percent response rates and is more effective than medication alone. SSRIs at higher-than-typical doses (e.g., fluoxetine 60 to 80 mg, sertraline 200 mg) are first-line pharmacotherapy, with response rates of 40 to 60 percent and 8 to 12 weeks for full effect. Combining ERP and SSRI is often more effective than either alone. Treatment-resistant OCD may benefit from clomipramine, antipsychotic augmentation, or, in severe cases, deep brain stimulation.",{"question":151,"answer":152},"How long does OCD last?","OCD is typically chronic if untreated, with symptoms often beginning in childhood, adolescence, or early adulthood (mean onset around age 19) and persisting for years or decades. Without treatment, only about 20 percent of cases remit spontaneously. With ERP and pharmacotherapy, 60 to 70 percent of patients achieve clinically meaningful improvement, though residual symptoms are common. The course can be episodic or continuous; stress often exacerbates symptoms. Continuing SSRI medication after remission is recommended for most patients to prevent relapse.",{"question":154,"answer":155},"Can OCD be cured?","OCD is generally managed rather than cured, but many patients achieve substantial functional recovery with evidence-based treatment. ERP delivered with high fidelity by a trained clinician produces durable symptom reduction, and patients who learn the skills tend to maintain gains long-term. Approximately 60 to 70 percent of patients respond to first-line treatment, and a meaningful subset achieve full remission. Lifetime relapse risk remains, particularly during stressful life events. Maintenance ERP skills practice and continuing medication for at least 1 to 2 years after remission reduce relapse rates significantly.","Obsessive-Compulsive Disorder",true,"~19","\u002Fconditions\u002Focd","2-3%","1:1","60-70%",{"title":5,"description":67},"ocd",[166,169,173,177,180,184],{"title":167,"citation":168,"icon":14},"Y-BOCS Validation","Goodman WK, Price LH, et al. The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006-1011.",{"title":170,"citation":171,"icon":172},"DSM-5-TR Criteria","American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). 2022.","ph:book-open",{"title":174,"citation":175,"icon":176},"ERP Treatment Efficacy","Olatunji BO, Davis ML, et al. Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome. Clin Psychol Rev. 2013;33(8):1206-1217.","ph:shield-check",{"title":178,"citation":179,"icon":72},"Neurobiological Model","Menzies L, Chamberlain SR, et al. Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder. Neurosci Biobehav Rev. 2008;32(3):525-549.",{"title":181,"citation":182,"icon":183},"SSRI Pharmacotherapy","Soomro GM, Altman D, et al. Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev. 2008;(1):CD001765.","ph:pill",{"title":185,"citation":186,"icon":187},"Comorbidity Patterns","Ruscio AM, Stein DJ, et al. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53-63.","ph:intersect","conditions\u002Focd",[190,196,201,207,214],{"name":191,"type":192,"description":193,"efficacy":194,"notes":195,"icon":176},"ERP (Exposure and Response Prevention)","First-line","Gradual exposure to triggers while preventing compulsive responses.","60-70% response rate","First-line; typically 12-20 sessions",{"name":197,"type":192,"description":198,"efficacy":199,"notes":200,"icon":183},"SSRIs","Higher doses than depression (e.g., fluoxetine 60-80mg)","40-60% response rate","Takes 10-12 weeks for full effect; often combined with ERP",{"name":202,"type":203,"description":204,"efficacy":205,"notes":206,"icon":72},"CBT with Cognitive Restructuring","Adjunct","Addresses dysfunctional beliefs about responsibility and threat","Enhances ERP outcomes","Targets inflated responsibility, thought-action fusion",{"name":208,"type":209,"description":210,"efficacy":211,"notes":212,"icon":213},"ACT (Acceptance and Commitment Therapy)","Alternative","Focuses on psychological flexibility rather than symptom reduction","Emerging evidence; useful for treatment-resistant cases","Teaches willingness to experience intrusive thoughts","ph:heart",{"name":215,"type":216,"description":217,"efficacy":218,"notes":219,"icon":220},"Deep Brain Stimulation (DBS)","Treatment-resistant","Neurosurgical intervention for severe, refractory OCD","40-60% response in treatment-resistant cases","Reserved for cases failing multiple treatments","ph:lightning-a","E5tg2y-7zqXbgFUdSqQFMKjDlzntufbu58TElriFvUs"]