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Obsessive-compulsive disorder

Última revisión: 19 Aug 2025
Última actualización: 20 Aug 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • obsessions
  • compulsions
  • sensory phenomena
  • schizotypal personality disorder
  • tic disorder
  • poor motor coordination
  • sensory perceptual difficulties
  • difficulties in sequencing of complex motor tasks
Todos los datos

Otros factores de diagnóstico

  • male sex
Todos los datos

Factores de riesgo

  • family history of obsessive-compulsive disorder (OCD)
  • PANDAS/PANS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection/pediatric acute-onset neuropsychiatric syndrome)
  • pregnancy
  • male sex (earlier onset, more chronic course, treatment resistance)
  • higher frequency of compulsions (treatment resistance)
  • early age of onset (treatment resistance)
  • previous hospitalizations for obsessive-compulsive disorder (OCD [treatment resistance])
  • schizotypal personality disorder (treatment resistance)
  • tic disorder (treatment resistance)
  • specific or diffuse brain structural abnormalities (treatment resistance)
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • no initial test
Todos los datos

Pruebas diagnósticas que deben considerarse

  • Structured Clinical Interview for the DSM (SCID)
  • Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)
  • Clinical Global Impression (CGI)
Todos los datos

Algoritmo de tratamiento

Agudo

mild to moderate symptoms: without comorbid personality disorders or dissociative symptoms

severe symptoms or with comorbid personality disorders or dissociative symptoms

Colaboradores

Autores

Phillip J. Seibell, MD, FAPA
Phillip J. Seibell

OCD and Anxiety Psychiatry of Westchester, P.C.

Hawthorne

NY

Divulgaciones

PJS declares that he has no competing interests.

Stefano Pallanti, MD, PhD
Stefano Pallanti

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 topic.

Silvia Bernardi, MD
Silvia Bernardi

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 topic.

Megan Hughes-Feltenberger, PhD
Megan Hughes-Feltenberger

Clinical Assistant Professor of Psychology in Psychiatry

Weill Cornell Medicine

New York

NY

Disclosures

MHF declares that she has no competing interests.

Eric Hollander, MD
Eric Hollander

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 has received research grants from Jazz, Roche, and Compass.

Acknowledgements

The authors would like to gratefully acknowledge Dr Ashley Braun, a previous contributor to this topic. AB declares that she has no competing interests.

Peer reviewers

Darin D. Dougherty, MD

Director

Division of Neurotherapeutics

Massachusetts General Hospital

Boston

MA

Disclosures

DDD has received research funding and honoraria from Medtronic. DDD has served as an advisor and received honoraria from Sage, Celenase, and Boehringer-Ingelheim. DDD has served as an advisor and received equity from Neurable, Innercosmos, and Intrinsic Powers.

Robert Hudak, MD

Associate Professor of Psychiatry

University of Pittsburgh School of Medicine

Pittsburgh

Pennsylvania

PA

Disclosures

RH declares that he has no competing interests.

Juliana Belo Diniz, MD

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.

Amit Nigam, MBBS, MRCPsych

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

World Health Organization. International statistical classification of diseases and related health problems. 11th revision. Jan 2022 [internet publication].Full text

American Psychiatric Association. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Jul 2007 [internet publication].Full text

American Psychiatric Association. Guideline watch (March 2013): practice guideline for the treatment of patients with obsessive-compulsive disorder. Mar 2013 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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