Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- obsessions
- compulsions
- schizotypal personality disorder
- tic disorder
- poor motor coordination
- sensory perceptual difficulties
- difficulties in sequencing of complex motor tasks
Risk factors
- FHx of OCD
- PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection)
- pregnancy
- male gender (earlier onset, more chronic course, treatment resistance)
- higher frequency of compulsions (treatment resistance)
- early age of onset (treatment resistance)
- previous hospitalisations for OCD (treatment resistance)
- schizotypal personality disorder (treatment resistance)
- tic disorder (treatment resistance)
- specific or diffuse brain structural abnormalities (treatment resistance)
Diagnostic investigations
Investigations to consider
- structured clinical interview for the DSM (SCID)
- Yale-Brown Obsessive-Compulsive Scale
- clinical global impression (CGI)
Treatment algorithm
Contributors
Authors

OCD and Anxiety Psychiatry of Westchester, P.C.
Hawthorne
NY
Disclosures
PJS has received honoraria from Slack, Inc., for guest editing an issue on OCD.

Professor of Psychiatry
Institute of Neuroscience
Florence
Italy
Disclosures
SP declares that he has no competing interests. SP is an author of several references cited in this monograph.

Project Manager
New York State Psychiatric Institute
Columbia University
New York
NY
Disclosures
SB receives research sponsorship from NYSPI, APA, and the Brain & Behavior Research Foundation. SB is also a board member of the New York council on Problem Gambling. SB is an author of a reference cited in this monograph.

Assistant Professor of Psychology in Psychiatry
Assistant Director of Education for Psychology
Weill Cornell Medical College
Assistant Attending Psychologist
NewYork-Presbyterian Hospital
New York
NY
Disclosures
MHF declares that she has no competing interests.

Clinical Professor of Psychiatry and Behavioral Sciences
Director
Compulsive, Impulsive and Autism Spectrum Disorder Program
Albert Einstein College of Medicine
Montefiore Medical Center
New York
NY
Disclosures
EH declares that he has no competing interests.
The authors would like to gratefully acknowledge Dr Ashley Braun, a previous contributor to this monograph. AB declares that she has no competing interests.
Peer reviewers
Psychiatrist
Department and Institute of Psychiatry
Clinical Hospital
University of Sao Paulo Medical School
Sao Paulo
Brazil
Disclosures
JBD declares that she has no competing interests.
Specialist Registrar in Forensic Psychiatry and Honorary Research Worker
National OCD Service
Queen Elizabeth II Hospital
Welwyn Garden City
Forensic Psychiatrist
West London Mental Health NHS Trust
London
UK
Disclosures
AN declares that he has no competing interests.
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