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Obsessive-Compulsive Disorder (OCD)

Matthew J. Filippo, DO and Chelsea Karson, Doctor of Medicine Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A behavioral disorder characterized by pathologic obsessions (recurrent intrusive thoughts, ideas, or images) and/or compulsions (repetitive, ritualistic behaviors or mental acts) ca...

DIAGNOSIS

HISTORY

  • Obsessions, compulsions or both, which cause marked distress, are time-consuming (>1 hr/day), and cause significant occupational/social impairment.

  • Two criteria support the diagnosi...

TREATMENT

GENERAL MEASURES

  • Exposure with Response (Ritual) Prevention, a type of Cognitive Behavioral Therapy (CBT) composed of typically graded exposures with response prevention and cognitive therapy...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Y-BCOS survey to track progress 

  • Continue medication 1 to 2 years at full dose, the taper of 12.5–25% q 1–2 mo.

Patient Monitoring

Monitor for decrease in obsessions...

REFERENCES

1
Goodman WK, Grice DE, Lapidus KA, et al. Obsessive-compulsive disorder. Psychiatr Clin North Am. 2014;37(3):257–267.
2
American Psychiatric Association. Practice guideline for the treatment ...

CODES

ICD10

  • F42 Obsessive-compulsive disorder

  • F42.2 Mixed obsessional thoughts and acts

  • F42.3 Hoarding disorder

  • F42.4 Excoriation (skin-picking) disorder

  • F42.8 Other obsessive-compulsive disorder

  • F42.9 Obse...

CLINICAL PEARLS

  • Exposure with Response (Ritual) Prevention, a type of CBT composed of graded exposures with response prevention and cognitive therapy is recommended as first-line treatment.

  • ERP plus an...

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