Obsessive-compulsive disorder

A debilitating psychiatric disorder characterized by anxiety-provoking intrusive thoughts (obsessions) that lead to stereotyped motor, cognitive acts, or rituals that are performed (compulsions) to relieve the associated anxiety 1).

It affects up to 2% of the population and is the 10th leading cause of disability worldwide 2) 3).

12–20% of cases remain refractory to standard behavioral psychotherapy and medical treatment with serotonin reuptake inhibitors (SSRI) or atypical antipsychotics 4).

DBS targets explored for OCD include the anterior limb of the internal capsule (ALIC), nucleus accumbens (NAc), ventral capsule / ventral striatum (VC/VS), subthalamic nucleus (STN), and inferior thalamic peduncle (ITP) 5) 6)

The FDA recently granted a humanitarian device exemption approving the use of VC/VS DBS for medically intractable OCD.

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions.

Include excessive washing or cleaning, repeated checking, extreme hoarding, preoccupation with sexual, violent or religious thoughts, relationship-related obsessions, aversion to particular numbers and nervous rituals such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms are time-consuming, might result in loss of relationships with others, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, people with OCD generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization.

A number of psychological and biological factors may be involved in causing obsessive-compulsive disorder.

Other disorders with similar symptoms include obsessive-compulsive personality disorder (OCPD), an autism spectrum disorder, or disorders where perseveration (hyperfocus) is a feature in ADHD, PTSD, bodily disorders, or just a habit problem.

Standardized rating scales such as Yale Brown Obsessive Compulsive Scale can be used to assess the severity of symptoms.

Shah DB, Pesiridou A, Baltuch GH, et al. Functional neurosurgery in the treatment of severe obsessive compulsive disorder and major depression: overview of disease circuits and therapeutic targeting for the clinician. Psychiatry (Edgmont). 2008; 5:24–33
Narrow WE, Rae DS, Robins LN, et al. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. Arch Gen Psychiatry. 2002; 59:115–123
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997; 349:1436–1442
Eisen JL, Goodman WK, Keller MB, et al. Patterns of remission and relapse in obsessive-compulsive disorder: a 2-year prospective study. J Clin Psychiatry. 1999; 60:346–51; quiz 352
Greenberg BD, Gabriels LA, Malone DA, Jr, et al. Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Mol Psychiatry. 2010; 15:64–79
Sturm V, Lenartz D, Koulousakis A, et al. The nucleus accumbens: a target for deep brain stimulation in obsessive-compulsive- and anxiety-disorders. J Chem Neuroanat. 2003; 26:293–299
  • obsessive-compulsive_disorder.txt
  • Last modified: 2022/01/04 10:50
  • by