Obsessive-compulsive disorder
OCD
Research on recurring unwanted thoughts, repetitive actions, and the learning processes that may underlie them.
Research question
How closely do avoidance habits measured in experiments relate to the frequency of compulsions in daily life?
Findings
Obsessions and compulsions
Obsessions are recurring unwanted thoughts, images, or urges. Compulsions can include repetitive behaviors and mental rituals.
Avoidance habits in a laboratory task
In an experiment with 25 participants in each group, the OCD group made more avoidance responses than controls after repeated training when a cue no longer signaled an unpleasant outcome.
Genome-wide associations across 28 cohorts
A pooled analysis of 53,660 OCD cases and 2,044,417 controls of European ancestry identified 30 genomic loci associated with OCD. Some cohorts defined cases through self-report.
Subcortical structures in adults and children
ENIGMA pooled MRI data from 1,830 people with OCD and 1,759 controls. Adults with OCD had smaller hippocampal and larger pallidal volumes on average than controls. A subgroup of unmedicated children with OCD had larger thalamic volumes than pediatric controls.
Twelve-week results in children and adolescents
In the POTS randomized trial of 112 participants aged 7 to 17, the cognitive behavioral therapy, sertraline, and combined treatment groups showed larger reductions in OCD symptom scores than the placebo group over 12 weeks. The result applies to the trial’s symptom measure and follow-up period.
Educational attainment in a sibling comparison
A Swedish birth cohort included 2,115,554 people, of whom 15,120 had recorded OCD. In the full cohort, the adjusted odds ratio for finishing upper secondary education was 0.43 (95% CI 0.41–0.44) for people with OCD. Comparisons between full siblings discordant for OCD showed a similar pattern. Factors that siblings do not share can still confound the association.
Co-occurring disorders in OCD clinics across seven countries
Researchers pooled summary data from OCD clinics in seven countries on 3,711 adults with a primary OCD diagnosis. Current major depression was recorded in 1,055 patients (28.4%), and current generalized anxiety disorder in 716 (19.3%). The clinical samples came from centers with different recruitment and assessment procedures.
Limitations
The avoidance finding comes from a small laboratory sample. Further studies are needed to establish whether it generalizes to the range of compulsions people experience in daily life.
Original sources
Obsessive–compulsive disorder
Dan J. Stein et al.
Enhanced avoidance habits in obsessive-compulsive disorder
Claire M. Gillan et al.
Genome-wide analyses identify 30 loci associated with obsessive–compulsive disorder
Strom et al.
Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis
Premika S. W. Boedhoe et al.
Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial
Pediatric OCD Treatment Study (POTS) Team
Association of Obsessive-Compulsive Disorder With Objective Indicators of Educational Attainment: A Nationwide Register-Based Sibling Control Study
Ana Pérez-Vigil et al.
Comorbidity, age of onset and suicidality in obsessive-compulsive disorder (OCD): An international collaboration
Vlasios Brakoulias et al.