Last reviewed: September 2018
Last updated: November  2017



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)
Full details

Treatment algorithm


Authors VIEW ALL

Phillip J. Seibell

OCD and Anxiety Psychiatry of Westchester, P.C.




PJS has received honoraria from Slack, Inc., for guest editing an issue on OCD. He will receive honoraria for guest editing a similar issue in 2017. PJS has received honoraria and travel expenses from the Nevada Psychiatric Association for presenting a talk on The Psychopharmacology of OCD and Hoarding Disorder.

Stefano Pallanti

Professor of Psychiatry

Institute of Neuroscience




SP declares that he has no competing interests. SP is an author of several references cited in this monograph.

Silvia Bernardi

Project Manager

New York State Psychiatric Institute

Columbia University

New York



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.

Megan Hughes-Feltenberger

Assistant Professor of Psychology in Psychiatry

Assistant Director of Education for Psychology

Weill Cornell Medical College

Assistant Attending Psychologist

NewYork-Presbyterian Hospital

New York



MHF declares that she has no competing interests.

Eric Hollander

Clinical Professor of Psychiatry and Behavioral Sciences


Compulsive, Impulsive and Autism Spectrum Disorder Program

Albert Einstein College of Medicine

Montefiore Medical Center

New York



EH receives a research grant from Brainsway. EH is an author of several references cited in this monograph.

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 VIEW ALL


Department and Institute of Psychiatry

Clinical Hospital

University of Sao Paulo Medical School

Sao Paulo



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




AN declares that he has no competing interests.

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