Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder that often begins early in childhood. Patients with OCD are known to seek help late after disorder onset, and therefore have a long duration of untreated illness (DUI), which is found to correlate with negative clinical outcomes. No meta-analysis has previously investigated this issue.

Our protocol was pre-registered with PROSPERO (CRD42020165226). We followed PRISMA-guidelines and searched for relevant articles in four electronic databases. Meta-analyses of means based on random-effects (Der-Simonian-and-Laird-method) were used to derive the pooled estimates. Subgroup-analyses and meta-regressions were conducted to explore possible factors affecting help-seeking and DUI.

We included N = 31 studies in the quantitative synthesis, with 16 studies proving data for age at help-seeking and 16 studies providing data for duration of untreated illness. The pooled mean age at help-seeking was 28.66 years (95 % CI: 27.34-29.98), while the pooled mean interval between age at disorder onset and help-seeking was 6.97 (95 % CI: 5.69-8.24), and the pooled mean duration of untreated illness was 80.23 months (68.72-91.75), around 6.69 years, all with p < 0.001. Specific OCD-related factors affected help-seeking and duration of untreated illness.

Patients with OCD seek for help late in the course of the disorder and have a long duration of untreated illness, which is associated with more negative prognosis. This meta-analysis confirms the long duration of untreated illness in OCD and proposes possible factors associated with the length of the help-seeking process and DUI.

Intolerance of uncertainty (IU) is a transdiagnosed vulnerability for many mental disorders. Habit is a potential cognitive construct that links to intolerance of uncertainty and symptom dimensions. This study adopted a transdiagnose perspective to investigate the mediation effect of habit features between symptom dimensions and intolerance of uncertainty in a Chinese community sample.

We recruited 4102 Chinese adults age ranged from 18 to 67 (M = 26.9, SD = 8.01) to extract psychopathological symptom dimensions and explore the mediation roles of habit features.

The study extracted three symptom dimensions (compulsivity, addiction and affective stress dimension). All symptom dimensions, IU and habit features were significantly related (p < 0.01). IU had a direct positive influence on all three dimensions (compulsivity: effect = 0.41; affective stress: effect = 0.58; addiction: effect = 0.13), it lso have an indirect positive impact via habit feature of automaticity (compulsivity: effect = 0.095; affective stress: effect = 0.062; addiction: effect = 0.050). Additionally, IU can positively influence compulsivity dimension (effect = 0.053) and negatively affective stress (effect = -0.026) dimension through routine feature of habit.

Higher level of IU can intensify symptom dimension by habit feature of automaticity, while habit feature of routine can alleviate affective stress dimension and aggravate compulsivity dimension.

Previous studies have indicated a potential link between the gut microbiota and obsessive-compulsive disorder (OCD). However, the exact causal relationship remains uncertain. In this study, we employed a two-sample Mendelian randomization (MR) analysis to evaluate the causal connection between gut microbiota and OCD.

We collected Genome-Wide Association Study (GWAS) summary data on gut microbiota (n = 18, 340) and OCD (n = 199, 169), using single nucleotide polymorphisms (SNPs) as the instrumental variable. SNPs with an F-statistic of <10 were deemed weak instrumental variables and subsequently excluded. The MR analysis was conducted using five methods: inverse variance weighting (IVW), MR Egger, weighted median, weighted mode, and simple mode. Heterogeneity and pleiotropy were assessed using Cochran's Q-test and MR Egger intercept test, while sensitivity analysis was performed using a leave-one-out approach.

The IVW analysis revealed that at the phylum level, Proteobacteria (OR = 0.545, 95%CI: 0.347-0.855, P = 0.008) served as a protective factor for OCD, whereas at the order level, Bacillales (OR = 1.327, 95%CI: 1.032-1.707, P = 0.027) was identified as a risk factor. At the family level, Ruminococcaceae (OR = 0.570, 95%CI: 0.354-0.918, P = 0.021) also acted as a protective factor. At the genus level, Bilophila (OR = 0.623, 95%CI: 0.425-0.911, P = 0.015) was a protective factor, while Eubacterium ruminantium group (OR = 1.347, 95%CI: 1.012-1.794, P = 0.041) and Lachnospiraceae UCG001 (OR = 1.384, 95%CI: 1.003-1.910, P = 0.048) were identified risk factors. Reverse MR analysis showed no significant causal relationship between OCD and the gut microbiota, with no significant heterogeneity or horizontal pleiotropy observed.

Our analysis suggested that specific gut microbiota might have a causal relationship with OCD, revealing potential intervention strategies for the prevention and treatment of this disorder.

According to current models of compulsive checking, memory confidence greatly contributes to the development and maintenance of checking behaviours. However, how to intervene in memory confidence in an evidence-based manner has not yet been fully understood. Thus, the purpose of the current paper was to identify the factors influencing memory confidence through the review of experimental evidence.

PubMed, Google Scholar, OpenGrey and ProQuest databases were searched by combining two sets of keywords related to memory confidence and checking. Our search yielded 24 experiments. Due to the considerable heterogeneity of the studies regarding questionnaires, tasks and paradigms used, data were synthesized using a narrative review approach.

Six factors emerged from a thorough review of the literature, including negative memory belief, higher memory standard, inflated sense of responsibility, familiarization with the checked stimuli, number of checks and anxious valence of the checked stimuli.

The findings have important implications for the treatment of compulsive checking. We suggested general guidelines to translate these factors into a novel intervention to increase memory confidence in compulsive checkers.

Cross-sectional studies have reported neurocognitive performance deficits in obsessive-compulsive disorder (OCD), particularly on tasks assessing response inhibition and proactive control over stimulus-driven behaviors (task control). However, it is not clear whether these deficits represent trait-like markers of OCD or are state-dependent.

This study examined performance on two neurocognitive tasks in OCD patients (N = 26) before and after cognitive behavioral therapy (CBT) and matched healthy controls (HCs, N = 19). Tasks included the stop-signal task (assessing response inhibition) and the Object Interference (OI) task (assessing a specific form of task control). OCD patients completed these tasks and clinical ratings before and after 17 sessions of CBT delivered by expert therapists over two months. HCs completed tasks before and after 2-months. This design used CBT as a tool to reduce OCD symptoms to determine whether neurocognitive performance similarly improves.

Results showed that OCD patients and HCs did not significantly differ in their stop-signal performance at either time point. In contrast, OCD patients exhibited impaired performance on the OI task at baseline and their OI performance improved after treatment, resolving the deficit relative to HC.

The sample size was small, particularly for the healthy control group. We also tested only two neurocognitive tasks. Future study with larger sample sizes and more tasks is warranted.

These results suggest that task control deficits in OCD may be sensitive to symptom state. The possibility that improving task control represents a neurocognitive mechanism of successful CBT represents an important direction for future research.

The peripartum is a time of increased risk for the development or worsening of obsessive-compulsive (OC) symptoms. Existing evidence suggests that OC symptoms commonly surge immediately postpartum followed by a gradual recovery. Yet how societal conditions, such as a widespread public health crisis, may affect this pattern remains unknown. Increased OC symptom prevalence in the general population during the COVID-19 pandemic coupled with the pre-existing vulnerability of peripartum women suggests they may have been at particularly high risk for sustained symptoms. Thus, the aim of the current study was to examine trajectories in OC symptoms, particularly contamination concerns, in women who gave birth during the COVID-19 pandemic, and to look at risk and resiliency factors that may influence symptom course METHODS: A sample of 164 US pregnant women were recruited during the COVID-19 pandemic. They reported OC symptoms at 3 timepoints: April/May, 2020, July, 2020, and February, 2022. We used a growth mixture modeling approach to examine OC symptom trajectories from pregnancy through the postpartum across these timepoints, comparing the goodness of fit of models with 1-5 trajectory classes for overall OC symptoms and for contamination-related OC symptoms.

For total OC symptoms, two classes of trajectories were identified: recovering (29.27%) versus stable low (70.73%) symptoms; for contamination symptoms alone, a subset of total symptoms, three trajectories were identified: recovering (8.54%), stable low symptoms (68.29%), and stable high symptoms (23.17%). Peripartum stress, but not sociodemographic or obstetric factors, predicted class membership.

These findings suggest that peripartum OC symptoms, particularly related to contamination, may persist beyond the postpartum period in some women, particularly for women exposed to elevated stress in pregnancy and the postpartum.

Prediction of future psychosis in individuals with obsessive and compulsive (OC) symptoms is crucial for treatment choice, but only a few predictors have been revealed. Although OC symptoms and psychotic experiences (PEs) are common in adolescence, no studies have revealed the predictors of subsequent PEs in adolescents with OC symptoms. We aimed to explore the predictors for subsequent PEs among adolescents with OC symptoms, using a data-driven machine-learning approach on an adolescent cohort.

We used data from a cohort study on the general population of adolescents in Tokyo (n = 3171 at age 10). Data were collected at age 10, 12, 14, and 16. We focused on a subgroup of participants who had OC symptoms at age 12. Participants who had PEs at age 10 were excluded. A machine learning method was utilized to explore over 600 potential predictors at baseline, distinguishing between those who had an onset of PEs after age 14 (n = 45) and those who never had PEs (n = 99).

The predicting model demonstrated a good performance (test area under the curve = 0.80 ± 0.05). Other than known risk factors for PEs, novel predictors of subsequent PEs among adolescents with OC symptoms included: lack of interaction with people of different ages, desire to be like their father in the future, and nonworking of primary caregiver when they were 5 years old. Not sharing their belongings readily with other children was a strong predictor of having no PEs.

Close-knit family bonds and limited social connections outside the family predict the later PEs among adolescents with OC symptoms.

Obsessive-Compulsive Disorder (OCD) may involve an imbalance between goal-directed and habitual learning systems, and this study investigates the structural and functional brain networks underpinning these systems in OCD. Using predefined brain regions, structural and functional connectivity networks were constructed, and methods such as network-based statistics, average connectivity strength, structural-functional coupling, and partial least squares path modeling were employed to compare OCD patients and healthy controls. The results revealed that OCD patients showed increased structural connectivity within both the goal-directed and habitual learning networks, particularly in the subnetwork that connects these systems. However, functional connectivity strength was reduced in both the habitual learning network and the subnetwork connecting goal-directed and habitual learning systems. The symptoms of ordering and hoarding are, to some extent, correlated with the structural-functional coupling network and network characteristics. These findings suggest that alterations in both structural and functional brain networks underpin goal-directed and habitual learning in OCD, with increased structural connectivity potentially reflecting compensatory mechanisms, while reduced functional connectivity may contribute to the symptoms of OCD. Further research is required to better understand the complex interplay between these learning systems in OCD, considering symptom heterogeneity and disease's progression.

Selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacological treatment for obsessive-compulsive disorder (OCD). However, insufficient response is common and it remains unclear whether specific patient-level factors influence the likelihood of treatment response.

To determine the efficacy and acceptability of SSRIs in adult OCD, and to identify patient-level modifiers of efficacy.

We conducted an individual patient data meta-analysis (IPDMA) of industry-sponsored short-term, randomised, placebo-controlled SSRI trials submitted for approval to the Dutch regulatory agency to obtain marketing approval for treating OCD in adults. We performed a two-stage meta-analysis, using crude data of available trials. The primary outcome was the difference in Yale-Brown Obsessive-Compulsive Scale (YBOCS) change between active treatment and placebo. Secondary outcomes were differences in response (defined as the odds ratio of ≥35% YBOCS point reduction) and acceptability (defined as the odds ratio for all-cause discontinuation). We examined the modifying effect of baseline characteristics: age, gender, illness severity, depressive symptoms, weight, illness duration and history of antidepressant use.

After excluding three trials because of missing data, we analysed results from 11 trials (79% of all submitted trials, n = 2372). The trial duration ranged from 10 to 13 weeks. Mean difference of SSRIs relative to placebo was 2.65 YBOCS points (95% CI 1.85-3.46, p < 0.0001), equalling a small effect size (0.33 Hedges' g). The odds ratio for response was 2.21 in favour of active treatment (95% CI 1.72-2.83, p < 0.0001), with a number needed to treat of seven. Patient characteristics did not modify symptom change or response. Acceptability was comparable for SSRIs and placebo.

Our IPDMA showed that SSRIs are well accepted and superior to placebo for treating OCD. The effects are modest and independent of baseline patient characteristics.

School-related functional impairment is common in children and adolescents with obsessive-compulsive disorder (OCD). However, little is known about the characteristics of youth with OCD who struggle in school, whether these struggles interfere with treatment outcomes, and whether treatment improves school-related function. Among 385 youth with OCD at a specialist clinic (mean age [sd] = 13.7 [2.5]; 63.1% girls), 21.6% had partial or no school attendance at intake. Among those who received specialist treatment (n = 322), clinical outcomes were similar in those with no or partial attendance vs. those with full attendance, although the latter group needed fewer treatment sessions and were less likely to take psychotropic medication. At post-treatment, 10.5% still had partial or no school attendance, and 22.8% of youths and 33.3% of parents reported significant school impairment, regardless of response status. Some youth with OCD may benefit from specific supported education and return to school strategies to complement regular evidence-based interventions.

Neuropathological changes, such as those found in obsessive-compulsive disorder (OCD), often include cortical morphological abnormalities. Neuroimaging research has indicated that individuals with OCD typically exhibit altered cortical thickness (CTh) through surface-based morphometry (SBM) analyses. Yet, the findings have been hit or miss, with inconsistent results across various studies. We are employing meta-analytic techniques on comprehensive brain imaging data to examine variations in CTh in patients with OCD. This approach could refine spatial precision in detection, thereby sharpening our diagnostic capabilities for OCD and paving the way for more targeted therapeutic interventions. The seed-based d mapping (SDM) method was utilized to perform a vertex-wise, coordinate-based meta-analysis (CBMA) examining CTh differences across whole-brain studies in OCD patients relative to healthy controls (HCs). This analytical approach systematically compared structural neuroimaging findings between clinical and control groups. A comprehensive review of existing research uncovered 9 relevant studies (containing 9 distinct datasets) examining CTh in OCD. The analysis incorporated data from 518 OCD patients and 449 HCs. The findings revealed significant cortical thinning in the left anterior cingulate and paracingulate gyri, along with the right insula among OCD patients. Conversely, increased CTh was observed in several left-hemisphere regions, including the lingual gyrus, orbital portion of the inferior frontal gyrus, and dorsolateral aspect of the superior frontal gyrus. Moreover, the meta-regression results indicated an inverse relationship between age and the thickness of the right insula cortex in those suffering from OCD. However, the analysis was constrained by the small pool of studies and samples, as well as incomplete data from certain participants, which hindered a thorough subgroup examination. Additionally, the results of the meta-regression should be viewed with caution, as they are based on a relatively limited number of studies. The analysis did show changes in CTh in certain brain areas for OCD patients, which adds to our knowledge of the intricate workings of OCD-related brain abnormalities. These insights could potentially serve as valuable landmarks for diagnosing and treating OCD. Clinical trial number: Not applicable.

Several lines of evidence point to a strong association between OCD and autism-spectrum disorder and broader autism phenotype. However, the extent and nature of overlapping autistic traits has not been completely understood.

A systematic review in Pubmed and Scopus databases was performed to compare autistic traits between OCD patients and healthy controls (December 1990 to March 2025). A random-effects meta-analyses were conducted.

Current meta-analysis included 27 studies consisting of 1677 patients with OCD and 1239 healthy controls. Compared to healthy controls, total autistic traits (g = 1.27, CI = 1.02, 1.53), also ratings in social-communication domain (g = 0.98, CI = 0.66, 1.31), and restricted/repetitive behaviors (RRBs) domain (g = 1.65, CI = 1.27, 2.04) were increased in OCD patients. OCD symptoms were more strongly related to RRBs domain scores (r = 0.34, CI = 0.19, 0.48) than social-communication domain scores (r = 0.18, CI = 0.09, 0.27).

OCD is associated with significant increases in both RRBs and social-communication domains. A substantial subset of OCD emerges in youth who have autistic traits, particularly RRBs. In adults, elevated social-communication scores might, at least partly, reflect the effect of chronic OCD symptoms on social functioning rather than true increase in this domain.

Objective: Classifying obsessive-compulsive disorder (OCD) using brain data remains challenging. Resting-state electroencephalography (EEG) offers an affordable and noninvasive approach, but traditional machine learning methods have limited its predictive capability. We explored whether convolutional neural networks (CNNs) applied to minimally processed EEG time-frequency representations could offer a solution, effectively distinguishing individuals with OCD from healthy controls. Method: We collected resting-state EEG data from 20 unmedicated participants (10 OCD, 10 healthy controls). Clean, 4-second EEG segments were transformed into time-frequency representations using Morlet wavelets. In a two-step evaluation, we first used a 2D CNN classifier using leave-one-subject-out cross-validation and compared it to a traditional support vector machine (SVM) trained on spectral band power features. Second, using multimodal fusion, we examined whether adding clinical and demographic information improved classification. Results: The CNN achieved strong classification accuracy (82.0%, AUC: 0.86), significantly outperforming the chance-level SVM baseline (49.0%, AUC: 0.45). Most clinical variables did not improve performance beyond the EEG data alone (subject-level accuracy: 80.0%). However, incorporating education level boosted performance notably (accuracy: 85.0%, AUC: 0.89). Conclusion: CNNs applied to resting-state EEG show promise for diagnosing OCD, outperforming traditional machine learning methods. Despite sample size limitations, these findings highlight deep learning's potential in psychiatric applications. Education level emerged as a potentially complementary feature, warranting further investigation in larger, more diverse samples.

Growing evidence has identified potential biomarkers of cognitive-behavioural therapy (CBT) efficacy in obsessive-compulsive disorder (OCD). Genetic and epigenetic mechanisms (e.g., polymorphisms, DNA methylation) contribute to OCD pathogenesis and CBT response variability, establishing them as a key research focus. To evaluate their associations with CBT outcomes in OCD, we conducted a systematic review of PubMed, Web of Science, CNKI, and Cochrane Library (from inception to January 2025), identifying eight studies that met rigorous inclusion criteria. The identified predictors included: (1) Genetic polymorphisms (BDNF); (2) Epigenetic modifications (DNA methylation of MAOA, SLC6A4, OXTR, PIWIL1, MIR886, PLEKHA1, KCNQ1, TRPM8, HEBP1, HTR7P1, MAPK8IP3, ENAH, RABGGTB (SNORD45C), MYEF2, GALK2, CEP192, and UIMC1). These markers may influence neural plasticity, neurotransmitter regulation, and related processes, providing molecular substrates for the observed treatment effects. Converging evidence suggests that distinct neurocognitive mechanisms may mediate CBT efficacy in OCD, particularly fear extinction learning and goal-directed behaviors (GDBs), which we analyze mechanistically. Future studies should integrate polygenic risk scores (PRS) with functional neuroimaging to dissect individual variability in CBT response, mainly through cortico-striato-thalamo-cortical (CSTC) circuit profiling. To our knowledge, this is the first systematic review synthesizing genetic and epigenetic predictors of CBT response in OCD; these findings provide compelling evidence for biomarkers for CBT personalization in OCD, advancing a novel precision psychiatry framework.

Currently, our understanding of the metabolic and immune pathways involved in obsessive-compulsive disorder (OCD), as well as the precise mechanisms by which metabolism and immunity impact brain activity and function, is limited. This study aimed to examine the alterations in serum metabolites, inflammatory markers, brain activity, and brain functional connectivity (FC) among individuals with OCD and investigate the relationship between these factors. The study included 55 individuals with moderate-to-severe OCD (either drug-naïve or not taking medication for at least eight weeks) and 54 healthy controls (HCs). The High-Performance Liquid Chromatography-Tandem Mass Spectrometry (HPLC-MS/MS) technique was used to detect serum metabolites, whereas the enzyme-linked immunosorbent assay (ELISA) was utilized to identify inflammatory markers. The FC of the brain was investigated using resting-state functional magnetic resonance immaging(rs-fMRI). The findings demonstrated that individuals with OCD exhibited significant alterations in 11 metabolites compared to HCs. In particular, 10 of these metabolites exhibited an increase, while one metabolite displayed a decrease. Additionally, individuals with OCD experienced a marked elevation in the levels of five inflammatory factors (TNF-α, IL-1β, IL-2, IL-6, and IL-12). Rs-fMRI analysis revealed that individuals with OCD exhibited atypical FC in various brain regions, such as the postcentral gyrus, angular gyrus, and middle temporal gyrus. These specific brain areas are closely associated with sensory-motor processing, cognitive control, and emotion regulation. Further stepwise multiple regression analysis revealed that serum metabolite levels, particularly phosphatidylcholine, and inflammatory markers such as IL-1β could predict alterations in brain FC among individuals diagnosed with OCD. In summary, this study uncovered that individuals with OCD exhibit alterations in serum metabolites, inflammatory markers, brain activity, and FC. The findings suggest that these metabolites and inflammatory markers might play a role in the development and progression of OCD by affecting brain activity and the FC of neural networks.

Backgrounds: Brain morphological biomarkers could contribute to understanding the treatment response in patients with obsessive-compulsive disorder (OCD). Multimodal neuroimaging addresses this issue by providing more comprehensive information regarding neural processes and structures. Objectives. The present study aims to investigate whether patients responsive to deep Transcranial Magnetic Stimulation (TMS) differ from non-responsive individuals in terms of electrophysiology and brain morphology. Secondly, to test whether multimodal neuroimaging is superior to unimodal neuroimaging in predicting response to deep TMS. Methods. Thirty-two OCD patients who underwent thirty sessions of deep TMS treatment were included in the study. Based on a minimum 50% reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores after treatment, patients were grouped as responders (n = 25) and non-responders (n = 7). The baseline resting state qEEG and magnetic resonance imaging (MRI) records of patients were recorded. Independent sample t-test is used to compare the groups. Then, three logistic regression model were calculated for only QEEG markers, only MRI markers, and both QEEG/MRI markers. The predictive values of the three models were compared. Results. OCD patients who responded to deep TMS treatment had increased Alpha-2 power in the left temporal area and increased volume in the left temporal pole, entorhinal area, and parahippocampal gyrus compared to non-responders. The logistic regression model showed better prediction performance when both QEEG and MRI markers were included. Conclusions. This study addresses the gap in the literature regarding new functional and structural neuroimaging markers and highlights the superiority of multimodal neuroimaging to unimodal neuroimaging techniques in predicting treatment response.

Comorbidity between Obsessive-Compulsive Disorder (OCD) and Attention Deficit/Hyperactivity Disorder (ADHD) appears complex in terms of etiology, phenomenology, and treatment. There is a need to identify possible factors which are related to the co-occurrence of OCD and ADHD in adults. Cognitive Disengagement Syndrome (CDS) may contribute to this comorbidity through its associations with ADHD, emotional dysregulation, cognitive processes, and neuropsychological deficits.

In this study, we compared CDS and various sociodemographic and clinical characteristics in OCD patients with (n = 44) and without ADHD (n = 72), and healthy controls (n = 43), using the Yale Brown Obsessive-Compulsive Scale, Wender Utah Rating Scale, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale, Barkley's Adult Sluggish Cognitive Tempo Rating Scale, Beck Depression Inventory, and Beck Anxiety Inventory.

In addition to contamination obsessions (OR = 7.733, p = 0.002), male gender (OR = 3.732, p = 0.031), high anxiety (OR = 1.053, p = 0.02), and high CDS symptoms (OR = 1.145, p = 0.037) were associated with comorbidity between OCD and ADHD.

We suggest that CDS may serve as a valuable construct for understanding the nature of comorbidity between OCD and ADHD.

Obsessive-compulsive disorder (OCD) has long been conceptualized as a neuron-centric disorder of cortico-striato-thalamo-cortical (CSTC) circuit dysregulation. However, a growing body of evidence is now reframing this narrative, placing astrocytes-once relegated to passive support roles-at the center of OCD pathophysiology. Astrocytes are critical regulators of glutamate and GABA homeostasis, calcium signaling, and synaptic plasticity, all of which are disrupted in OCD. Recent high-resolution molecular and proteomic studies reveal that specific astrocyte subpopulations, including Crym-positive astrocytes, directly shape excitatory/inhibitory balance and control perseverative behaviors by modulating presynaptic inputs from the orbitofrontal cortex. Disruptions in astrocytic neurotransmitter clearance and dopamine metabolism amplify CSTC circuit hyperactivity and reinforce compulsions. This review reframes OCD as a disorder of neuro-glial dysfunctions, proposing that targeting astrocytic signaling, metabolism, and structural plasticity may unlock transformative therapeutic strategies. By integrating human and animal data, we advocate for a glial-centric model of OCD that not only enhances mechanistic understanding but also opens new frontiers for precision treatment.

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) share overlapping features for which similar cognitive behavioral treatment (CBT) strategies can be employed. However, the comorbid presence of these conditions poses unique clinical considerations, and a nuanced approach to assessment, conceptualization, and treatment is needed when working with individuals with co-occurring OCD and PTSD. Treatment providers may not be aware of these nuances and may hold misconceptions about co-occurring OCD and PTSD, impacting their approach to assessment, conceptualization, and treatment. The current study sought to examine possible misconceptions among mental health treatment providers of differing specializations. Among 146 primarily CBT-oriented treatment providers (20.3% generalist, 13.0% PTSD specialist, 32.6% OCD specialist, and 34.1% OCD/PTSD specialist), exploratory factor analysis categorized misconceptions relating to Trepidation, Differential Diagnosis, Flexibility, OCD is Trauma, Trauma Misconceptions, and Compartmentalization. Overall, OCD specialists endorsed misconceptions most frequently, including those of Trepidation and underestimating the prevalence of trauma and PTSD in individuals with OCD. In contrast, PTSD specialists were more likely to endorse providing patients reassurance for their OCD-related fears, and OCD/PTSD providers were more likely to apply rigid Differential Diagnosis criteria not supported by research or diagnostic criteria to intrusive thoughts and safety behaviors. Misconceptions are explained through the lens of differing conceptualization and treatment approaches between areas of specialization.

Obsessive-compulsive disorder (OCD) is a debilitating condition prevalent in up to 2.3% of the population, yet obsessive-compulsive symptoms are commonly misidentified by mental health professionals, adversely impacting treatment recommendations. This study examined OCD misidentification rates across two different types of obsessions, the influence of misidentification on treatment recommendation, and attitudes associated with clinicians' decisions surrounding the diagnosis of OCD and treatment recommendations in a sample of 110 licensed psychologists. Results showed that over one-third (35.0%) of participants incorrectly diagnosed two vignettes, representing symptoms of sexual orientation OCD (SO-OCD) and symmetry. Of those who correctly diagnosed the vignettes, about half of participants (symmetry = 55.4%; SO-OCD = 47.1%) recommended exposure and response prevention (ERP) as the primary treatment choice. Participants who endorsed greater client empowerment were more likely to misdiagnose the SO-OCD vignette (t(108) = 2.97, p = 0.004). Less experience with evidence-based practice and negative attitudes toward evidence-based practice were associated with the choice of treatment other than ERP (t(71) = -2.98, p = 0.004 and t(72) = 3.40, p < 0.001, respectively). Elevated OCD misdiagnosis and its adverse impact on treatment recommendations, as well as knowledge of factors contributing to misdiagnosis and mistreatment, imply the need for greater education and training.

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions that significantly impair functioning. Obsessive-compulsive personality disorder (OCPD) co-occurs in 17-45% of OCD patients, worsening outcomes across multiple domains. Therefore, we aimed to study the impact of OCPD in more detail by analyzing selected comorbidities, emotional aspects, and sociodemographic data. This study assessed 78 OCD patients (average age 44.9 years, 34.61% OCPD), using Y-BOCS, BABS, BPAQ, BIS-11, YMRS, HDRS-17, and ASEX. Patients with comorbid OCPD had significantly worse outcomes in symptom severity (Y-BOCS = 0.0006), treatment duration (p = 0.0127), insight (BABS, p = 0.0185), aggression (p = 0.0266), impulsivity (p = 0.0469), depression (HDRS, p = 0.0178), mania (YMRS, p = 0.0003), and sexual dysfunction (ASEX, p = 0.008). OCPD was more prevalent in unemployed individuals (p = 0.046) and older patients (p = 0.009). No significant differences were found regarding gender, education, or relationship status. Obsessions and compulsions, such as contamination (p = 0.025), somatic (p = 0.018), ruminations (p = 0.003), and obsessional slowness (p = 0.007), were more common in the OCPD group. In the group with OCPD, aggression and OCD severity were correlated with increased levels of depression, which can be considered potential correlates of bipolarity in the relationship between OCD and OCPD. In conclusion, OCPD significantly worsens clinical outcomes in OCD across emotional, behavioral, and functional dimensions.

The recent International Classifications of Diseases-11 (ICD-11) distinction of complex- post-traumatic stress disorder (C-PTSD) from post-traumatic stress disorder (PTSD), has highlighted a research gap in exploring how C-PTSD may relate to obsessive-compulsive disorder (OCD) differently than PTSD. Mental health disorders and comorbidities appear to be greater in military veterans compared to the general population. Thus, this study aimed to explore potential differences in OCD severity between probable PTSD and probable C-PTSD in a national clinical sample of UK military veterans. Data from 428 veterans were analysed using a previously collected dataset. The survey assessed sociodemographic characteristics, military experiences, physical and mental health, and well-being. Results indicated significant differences in OCD severity between probable PTSD and probable C-PTSD. OCD severity significantly increased as C-PTSD symptom severity increased for veterans with probable C-PTSD. Though no significant association was identified between OCD severity and PTSD scores within the probable PTSD group, this finding should be interpreted with caution, as the small sample may have limited statistical power. Greater C-PTSD severity significantly predicted greater OCD severity, but PTSD scores did not. Disturbances of self-organisations (DSO) symptoms within C-PTSD were more strongly associated to OCD severity compared to PTSD symptoms, indicating a seemingly complex interplay between C-PTSD's cluster of symptoms and OCD severity. Future research should focus on replication involving larger veteran samples and the general population, incorporating clinician-administered assessments alongside self-report measures to enhance diagnostic accuracy.

Obsessive-Compulsive Disorder (OCD) is a debilitating mental health condition characterized by recurrent, intrusive thoughts and repetitive behaviors that significantly disrupt daily life. Medical students may be uniquely susceptible to obsessive compulsive symptoms due to their constant exposure to potential contaminants and infectious diseases during their training. Obsessive Compulsive symptoms among medical students are often overlooked, which can significantly impact their academic performance, well-being, and future career prospects. The prevalence and factors of obsessive compulsive symptom is not widely studied in low and middle income countries and there are limited studies in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of obsessive compulsive symptoms among medical students.

This was a cross-sectional study conducted among 370 students. The outcome variable was assessed using the Obsessive-Compulsive Inventory-Revised scale (OCI-R). The collected data were entered using kobo collect tool box version 1.3 and analyzed using SPSS version 25. Bivariable and multivariable logistic analysis was conducted to identify factors associated with Obsessive Compulsive symptoms and variables with P-values less than 0.05 were considered to have significant association with 95% confidence interval.

The probable prevalence of obsessive-compulsive disorder among medical and health science students was 28% with (95% CI: 26.4-32.7). Being female [AOR = 1.33(95%CI: 1.09, 2.18)], Depressive symptoms [AOR = 2.12(95%CI: 1.95, 4.06)], Maladaptive coping mechanism [AOR = 1.74 (95%CI: 1.23, 2.50)], and Poor sleep quality [(AOR = 1.48(95%CI: 1.08, 2.24)] were significantly associated with obsessive compulsive symptoms.

Obsessive Compulsive Symptom has a high probable prevalence among medical and health science students. Being female, experiencing depressive symptoms, employing maladaptive coping mechanisms, and having poor sleep quality were significantly associated with obsessive-compulsive disorder. Therefore, early detection, screening, and appropriate intervention for obsessive-compulsive symptoms in medical students are crucial.

Residential treatment represents an important level of care for adolescents with severe and/or treatment-refractory obsessive-compulsive disorder (OCD). Despite accumulating evidence supporting the treatment efficacy and cost-effectiveness of insurance-based intensive OCD treatment in residential settings, few data exist that characterize the population of adolescent patients utilizing this level of care. As a result, residential treatment may be poorly understood by patients, their families, and referring providers, which may delay appropriate treatment for adolescents with OCD. Here, we characterize the patient population at an intensive residential treatment center (RTC) and partial hospitalization program (PHP) for adolescents (Mage = 15.23) with a primary diagnosis of OCD.

We examine quantitative data collected from 168 adolescents admitted to the McLean OCD Institute for Children and Adolescents for the treatment of primary OCD or a related disorder over a three-year period. We also conduct analyses on a subset of patients (n = 120) who participated in the Child and Adolescent Routine Evaluation (CARE) Initiative (McLean Child Division-Wide Measurement-Based Care Program) to further characterize this patient population with a lens toward additional comorbidities and factors impacting prognosis.

The current paper describes the severity of symptom presentation, comorbidities, psychotropic medication profiles, and disruption to personal and family functioning. Analyses also include the prevalence of OCD subtypes and co-occurrence among varied presentations.

In addition to identifying common clinical presentations in an RTC/PHP, this paper further aims to detail best practices and clinical rationale guiding a specialty RTC/PHP to inform families, providers, and payors about the individuals that most benefit from this level of care.

Compulsive cleaning is a characteristic symptom of a particular subtype of obsessive-compulsive disorder (OCD) and is often accompanied by intense disgust. While overgeneralization of threat is a key factor in the development of obsessive-compulsive symptoms, previous studies have primarily focused on fear generalization and have rarely examined disgust generalization. A systematic determination of the behavioral and neural mechanisms underlying disgust generalization in individuals with contamination concern is crucial for enhancing our understanding of OCD.

In this study, we recruited 27 individuals with high contamination concerns and 30 individuals with low contamination concerns. Both groups performed a disgust generalization task while undergoing functional magnetic resonance imaging (fMRI).

The results revealed that individuals with high contamination concern had higher disgust expectancy scores for the generalization stimulus GS4 (the stimulus most similar to CS+) and exhibited higher levels of activation in the left insula and left putamen. Moreover, the activation of the left insula and putamen were positively correlated with a questionnaire core of the ratings of disgust and also positively correlated with the expectancy rating of CS+ during the generalization stage.

Hyperactivation of the insula and putamen during disgust generalization neutrally mediates the higher degree of disgust generalization in subclinical OCD individuals. This study indicates that altered disgust generalization plays an important role in individuals with high contamination concerns and provides evidence of the neural mechanisms involved. These insights may serve as a basis for further exploration of the pathogenesis of OCD in the future.

This study investigates the frequency and characteristics of obsessive-compulsive (OC) symptoms and Obsessive-Compulsive Personality Disorder (OCPD) in patients with Burning Mouth Syndrome (BMS).

Obsessive-Compulsive Disorder (OCD) is a chronic condition involving intrusive thoughts (obsessions) and repetitive behaviors (compulsions), while Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder characterized by specific traits such as perfectionism, rigidity and need for control. Both conditions frequently overlap, but their prevalence in patients with BMS has never been explored.

A total of 151 BMS patients were assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R), Compulsive Personality Assessment Scale (CPAS), Visual Analog Scale (VAS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety and Depression scales (HAM-A, HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Patients were grouped based on OCI and CPAS scores.

n = 123 (81.6%) of our sample were females, with a mean age of 63.19 ± 12.2 years. Clinically significant OC symptoms (OCI-R > 21) were observed in 41.7% of the sample, while 37% met OCPD criteria; both OC symptoms and OCPD were present in 24.5% of patients.

BMS patients show a high prevalence of OC symptoms and OCPD traits, which should be taken into account by clinicians and considered in the therapeutic approach, given that they could complicate symptom management.

By identifying these symptoms and traits through OCI-R and CPAS, clinicians may improve treatment strategies, in the perspective of a multidisciplinary tailored and personalized approach.

This systematic review examines psychiatric medications approved by the FDA for anxiety disorders, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) from 2008 to 2024 and describes the mechanism of action, indications for both labelled and off-label uses, evidence for efficacy, dosing and adverse effects for each medication.

The methodology involved a literature search of the PubMed database for studies published from 1 January 2008 to 31 December 2024 on FDA-approved psychiatric medications and phase III pipeline medications, using the keywords: "anxiety" OR "PTSD" OR "OCD" AND "psychopharm*" OR "medic*" OR "pharm*". The authors conducted independent assessments of the resulting articles and reached a consensus on eligible studies to include in this systematic review.

Our review revealed that, in the past 16 years, the FDA approved only two medications for anxiety disorders (a delayed-release form of duloxetine for generalized anxiety disorder and an extended-release form of lorazepam) and none for PTSD or OCD. We also identified 14 pipeline medications for anxiety disorders, eight for PTSD and one for OCD, all of which are currently in phase III clinical trials.

Our results showed a paucity of new medications for anxiety disorders and none for PTSD and OCD in the past 16 years. However, phase III psychiatric medications for anxiety disorders, PTSD and OCD seem to show several agents with novel mechanisms of action, various modes of administration, and improved side-effect profiles.

Few pharmacogenetic studies on the use of genetic variations to predict antidepressant response in obsessive-compulsive disorder (OCD) have been published. This study expanded on the limited literature on single nucleotide polymorphisms (SNPs) across previously identified putative susceptibility genes for OCD, by incorporating known functional regulatory elements for all genes of interest. We investigated 17 SNPs in 12 genes implicated in OCD risk in 206 European ancestry OCD patients with selective serotonin reuptake inhibitor (SSRI) antidepressant response data, examining functional polymorphisms in remote regulatory regions. No association was observed between any regulatory region markers tested and drug response. We observed nominally significant associations between SNPs within the serotonin 1B receptor (5HT1B; SNP rs1778258), SLIT and NTRK-like family member 5 (SLITRK5; SNP rs10450811), and fas apoptotic inhibitory molecule 2 (FAIM2; SNP rs706795), with response to any SSRI, which did not survive multiple comparisons. This study supports a potential role for a number of OCD-associated risk genes in response to antidepressant treatment, warranting further investigation.

Psychiatric disorders are highly heritable and polygenic, influenced by environmental factors and often comorbid. Large-scale genome-wide association studies (GWASs) through consortium efforts have identified genetic risk loci and revealed the underlying biology of psychiatric disorders and traits. However, over 85% of psychiatric GWAS participants are of European ancestry, limiting the applicability of these findings to non-European populations. Latin America and the Caribbean, regions marked by diverse genetic admixture, distinct environments and healthcare disparities, remain critically understudied in psychiatric genomics. This threatens access to precision psychiatry, where diversity is crucial for innovation and equity. This Review evaluates the current state and advancements in psychiatric genomics within Latin America and the Caribbean, discusses the prevalence and burden of psychiatric disorders, explores contributions to psychiatric GWASs from these regions and highlights methods that account for genetic diversity. We also identify existing gaps and challenges and propose recommendations to promote equity in psychiatric genomics.

Repetitive transcranial magnetic stimulation (rTMS) has the potential to increase the clinical effect of exposure with response prevention psychotherapy for obsessive-compulsive disorder (OCD). We investigated the use of task-based functional magnetic resonance imaging for predicting clinical outcomes to different rTMS protocols combined with exposure with response prevention in OCD.

Sixty-one adults with OCD underwent rTMS and exposure with response prevention and were randomized to different high-frequency rTMS conditions: left dorsolateral prefrontal cortex (n = 19), left presupplementary motor area (n = 23), and control stimulation at the vertex at low intensity (n = 19). The Tower of London task and stop signal task were used to assess pretreatment activation during planning and inhibitory control, respectively. We adopted a Bayesian region-based approach to test whether clinical improvement can be predicted by task-based functional magnetic resonance imaging-derived measures of task-related brain activation or functional connectivity between task-relevant regions and the bilateral amygdala.

For the vertex group, but not the dorsolateral prefrontal cortex/presupplementary motor area rTMS conditions, higher activation in several task-relevant regions during planning and response inhibition and lower error-related activation corresponded with better short-term clinical improvement. Lower precuneus activation with increased planning taskload was correlated with symptom reduction in the dorsolateral prefrontal cortex group. In the presupplementary motor area group, higher error-related activation and lower inhibition-related insular-amygdalar connectivity were associated with symptom reduction.

Pretreatment task-based functional magnetic resonance imaging-derived measures of activation and connectivity during planning and inhibition-related processes are associated with clinical response for specific rTMS conditions in OCD. Future placebo-controlled trials with larger sample sizes should combine clinical information and neural correlates to improve prediction of clinical outcome.

Dementia is a highly prevalent syndrome with various causes, characterized by cognitive deficit in one or more domains, with important impairment of functioning, which frequently presents with neuropsychiatric symptoms that may include obsessive-compulsive symptoms.

The main goal of this meta-analysis was to describe and determine the prevalence of obsessive-compulsive symptoms in dementia.

To accomplish that, MEDLINE, CENTRAL and Psycnet databases were searched from inception to March 2023. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data was applied. The principal summary measures were the mean of prevalence of obsessive-compulsive symptoms in patients with dementia and the number of each type of obsession or compulsion.

Of the 643 articles screened, 92 were accepted for full-text assessment. Of these, 30 with information on prevalence of obsessive-compulsive symptoms in dementia or any description of those were included, yielding a total of 37 cohorts (5 studies with two cohorts and 1 study with three cohorts). According to our results, obsessive-compulsive symptoms have considerable prevalence in dementia (35.3%, 23.1-47.6%), namely in frontotemporal dementia (48.4%, 29.8-67.0%); obsessive-compulsive symptoms were less frequent in other dementia diagnosis (17.6%, 9.1-26.2%). The more frequent obsessive contents are symmetry (28.6%) and somatic (20.0%); and the more frequent compulsions are checking (27.4%); hoarding is also a relevant symptom (27.8%).

There was considerable heterogeneity in the prevalence of obsessive-compulsive symptoms in frontotemporal dementia, that is, in part related with diagnostic criteria for dementia, as well as obsessive-compulsive symptom assessment. A careful distinction between compulsions and compulsive-like symptoms is fundamental. Hypervigilance for somatic symptoms and concerns about disease and mortality, as well as deficits in cognitive domains like attention and memory may explain why somatic obsessions and checking compulsions are more prevalent.

The present results indicate that obsessive-compulsive symptoms may be prevalent in the clinical course of many patients with dementia, especially frontotemporal dementia. Better instruments are needed to describe obsessive-compulsive phenomena in a reliable and comparable way, particularly in a population such as dementia patients, whose subjectivity is difficult to access.

The aim of this study was to map the association between Chronic Pain (CP) and Obsessive-Compulsive Disorder (OCD) in the present literature.

A scoping review was conducted with a comprehensive search of literature in peer-reviewed journals. Search parameters included articles written in English, published at any time, and including terms associated with both CP and OCD. Databases searched for purposes of this study included Psychinfo, Medline, Embase, Emcare, CINAHL, Scopus, Web of Science, Cochrane, and Google Scholar.

The review included 87 records, comprising 49 primary research and 38 secondary research records. Extracted information from these were grouped into four broad classifications. The Prevalence and Severity classification included information from 39 records which comprised: (1) primary research detailing current OCD prevalence rates in CP conditions (differentiated between general population and Pain/Medical/Hospital clinics); (2) primary research detailing lifetime OCD prevalence rates in CP conditions; (3) primary research detailing CP prevalence rates in OCD; (4) primary research detailing relationships between OCD and CP through psychometric measures; and (5) secondary research relating to prevalence rates. The Neurobiology classification included information from 28 records (primary and secondary research) detailing convergent and divergent neurobiological/neurophysiological aspects as reported for both OCD and CP. The Psychological Models/Factors classification included information from 7 records (primary and secondary research) detailing pain-related anxiety, neuropsychological measures, catastrophic thinking, preservative thinking, early maladaptive schemas, schema modes, childhood trauma experiences, and conditional associative learning, as reported for OCD and CP. The Intervention classification included information from 32 records which comprised: (1) primary research on neurosurgical, medication, and psychotherapeutic interventions; (2) secondary research on Deep Brain Stimulation; (3) secondary research on Medication; (4) secondary research on lesion, cingulotomy, and other surgical procedures; and (5) secondary research on other interventional procedures.

While there has been considerable and growing research in the fields of both OCD and CP over the years, focused research into their potential association has been limited and potentially overlooked. The results of this review, however, suggest a complex relationship between CP and OCD. Prevalence rates between the two conditions vary widely across different populations, although the underlying reason for this remains unclear at this stage. There are commonalities in terms of alterations in pain processing, the dysregulation of certain brain regions, and the abnormalities in neurotransmitter systems in both conditions. In their treatment, use can be made of overlapping pathophysiological processes, the convergent and divergent psychological aspects, and the range of interventional approaches that share targets to promote efficacy. However, the complex presentations of both OCD and CP make it a challenging relationship to accurately clarify. Further directed and robust, high-quality studies will be needed to expand our understanding of this area.

Obsessive-compulsive disorder (OCD) is a severe and disabling psychiatric disorder that impacts people all around the world. OCD has several different phenotypes, with intrusive visual images being a presentation of the disease. In this paper, a case is presented of a patient who suffers from intrusive visual images of a large spider and octopus with visualization of the tentacle on her body. These visual images were identified as a symptom of OCD; therefore, this paper aims to present this unique presentation of the disease.

According to the Dimensional Model of Adversity and Psychopathology (DMAP), childhood trauma (CT) can be categorised into two dimensions: abuse and neglect. While CT is widely recognized as a risk factor for obsessive-compulsive symptoms (OCS), the specific dimension that primarily contributes to this risk remains unclear. This study sought to distinguish the effects of different CT dimensions on the developmental trajectory of OCS. A total of 3535 Chinese college freshmen (Age Mean = 18.01, Age SD = 0.77; 65.60% female) participated in a 3-year, 5-waves longitudinal tracking study. A latent growth curve model (LGCM) was constructed to examine the effects of two CT dimensions (abuse and neglect) on the developmental trajectory of OCS. Sex and recent perceived stress were also added to the conditional LGCM. Results showed that the rates of 'moderate to severe' emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect were 3.68%, 3.62%, 5.57%, 10.46%, and 19.54%, respectively. The unconditional LGCM revealed a U-shaped developmental trajectory of OCS. The conditional LGCM revealed that childhood experiences of abuse, rather than neglect, significantly predicted the intercept (β = 0.159, p < 0.001), the linear slope (β = -0.222, p < 0.01), and the quadratic slope (β = 0.195, p < 0.05) of the trajectory of OCS. Specifically, higher abuse levels were associated with higher initial OCS levels and a slower rate in linear downtrend of OCS over time, resulting in a U-shaped trend. Besides, sex did not predict the developmental trajectory of OCS. These findings highlight the association between childhood experiences of abuse, rather than neglect, with the development of OCS and may provide targeted direction and guidance for preventing OCS among Chinese college students.

Pediatric obsessive-compulsive disorder (OCD) is a severely impairing disorder, associated with high levels of family accommodation (FA). Approximately 40 % of youth do not benefit from first-line treatment options (cognitive behavioral therapy or pharmacotherapy). Supportive Parenting for Anxious Childhood Emotions (SPACE) is a parent-based treatment, teaching parents to reduce FA and increase supportive parenting, thereby aiming to improve the child's OCD. This article presents the protocol of a multiple baseline single-case experimental design (SCED) study to test the efficacy of SPACE in reducing OCD severity and FA in youth with OCD.

This SCED consists of a baseline, treatment, and follow-up phase. In total 25 youth (7-18 years) with OCD, who previously received cognitive behavioral therapy (CBT) unsuccessfully, aborted treatment early, or were not able to receive CBT due to too high levels of OCD/anxiety, and their parents will be included. They will be randomly allocated to one of three baseline phase options (4, 6 or 8 weeks). The treatment phase consists of 12 weekly sessions of SPACE with parents. Throughout all phases, OCD severity and FA will be briefly assessed thrice a week. Standard clinical measurements assessing OCD severity and FA and secondary parameters will be conducted at six timepoints, till 6 months follow-up.

Combining the innovative SPACE treatment with a SCED provides detailed insight into the relationship between OCD and FA over time. Studying this in clinical practice in complex cases that are normally understudied, helps to improve more personalized care for youth with OCD.

There are very few studies exploring neuroplasticity impairments and neurodegeneration processes in obsessive-compulsive disorder (OCD). Additionally, the peripheral blood levels of neuroplasticity biomarkers in individuals with OCD and their associations with treatment outcomes remain largely unexplored. This study sought to compare peripheral blood levels of biomarkers reflecting neuroplasticity and neurodegenerative processes between patients with OCD and healthy controls (HCs) and to determine whether accelerated continuous theta-burst stimulation (cTBS) influences the levels of these biomarkers in OCD.

TThirty-three OCD patients participated in an open-label trial of cTBS. During the treatment, serum levels of 10 biomarkers of neuroplasticity and neurodegenerative processes were assessed at three-time points. Additionally, 42 HCs were enrolled.

The cTBS treatment was associated with significant improvements in OCD and depressive symptoms. Baseline levels of all biomarkers, except myeloperoxidase (MPO), were significantly lower in OCD patients compared to HCs after adjustment for covariates and multiple testing. The levels of platelet-derived growth factor-AA increased considerably following the cTBS treatment, but they remained significantly lower than in HCs at the follow-up. In turn, the levels of MPO significantly decreased during cTBS treatment and were substantially lower one month after the cTBS stimulations compared to HCs. A reduction in MPO levels was significantly and positively correlated with a reduction of OCD and depressive symptoms.

This study suggests that neuroplasticity biomarkers are reduced in patients with OCD. cTBS treatment is associated with symptom improvement, albeit with a limited impact on peripheral blood biomarkers reflecting neuroplasticity and neurodegenerative processes.