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Obsessive-Compulsive Disorder (OCD)

Reviewed 06/2022
 


BASICS

DESCRIPTION

  • An anxiety disorder characterized by pathologic obsessions (recurrent intrusive thoughts, ideas, or images) and compulsions (repetitive, ritualistic behaviors or mental acts) causing...

DIAGNOSIS

HISTORY

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

  • Two criteri...

TREATMENT

GENERAL MEASURES

  • Cognitive-behavioral therapy (CBT) composed of exposure with response prevention and cognitive therapy is recommended as first-line treatment (3)[A].

  • Five phases of treatment...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Y-BCOS survey to track progress  (5)

  • Continue medication 1 to 2 years at full dose, the taper of 12%–25% q 1–2 mo.

Patient Monitoring

Monitor for decrease in obsessi...

REFERENCES

1
Fenske JN, Petersen K. Obsessive compulsive disorder: diagnosis and management. Am Fam Physician. 2015;92(10):896–903.
2
Goodman WK, Grice DE, Lapidus KA, et al. Obsessive-compulsive disorde...

CODES

ICD10

  • F42 Obsessive-compulsive disorder

  • F63.9 Impulse disorder, unspecified

  • F63.3 Trichotillomania

  • F63.0 Pathological gambling

  • F63.89 Other impulse disorders

SNOMED

  • 191736004 Obsessive-compulsive disor...

CLINICAL PEARLS

  • CBT is the initial treatment of choice for mild OCD.

  • CBT plus an SSRI or an SSRI alone is the treatment choice for more severe OCD.

  • The majority of patients with OCD respond to first SSR...

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