Overview
Obsessive-compulsive disorder (OCD) is a mental health disorder characterized by obsessions and compulsions. Stimulant use can be associated with psychiatric comorbidities, including OCD 4.Diagnosis
Management
Transcranial direct current stimulation (tDCS) may reduce Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores in OCD patients 1.
Repetitive transcranial magnetic stimulation (rTMS) protocols, including excitatory rTMS of the bilateral dorsolateral prefrontal cortex (DLPFC) and inhibitory rTMS of the right DLPFC, may be effective for decreasing Y-BOCS scores 2.
Inpatient, residential, or day-patient treatment, often including cognitive-behavioral treatment with exposure and response prevention (ERP), leads to significant decreases in obsessive-compulsive symptoms 3.
Exposure and response prevention (ERP) has a definite effect on OCD, particularly when compared to placebo or drug control conditions 5. Longer session lengths are associated with better treatment effects 5.
Deep brain stimulation (DBS) is effective in patients with severe OCD resistant to pharmacological treatments, improving obsessive-compulsive, depressive, and anxiety symptoms, as well as global functioning 6.Special Populations
Psychiatric comorbidities such as depression, bipolar disorder, substance abuse disorder, and psychosis are frequently associated with OCD, suggesting shared etiological factors 4.Key Recommendations
Exposure and response prevention (ERP) is an effective treatment for OCD, with longer session lengths correlating with better outcomes 5. (Evidence: Strong)
Transcranial magnetic stimulation (TMS) protocols, including excitatory and inhibitory rTMS targeting specific prefrontal cortex areas, may be beneficial for reducing OCD symptom severity 2. (Evidence: Strong)
Inpatient, residential, or day-patient treatment programs incorporating ERP demonstrate significant reductions in obsessive-compulsive symptoms 3. (Evidence: Strong)References
1 Yan L, Wang Y, Li M. Transcranial direct current stimulation in patients with obsessive-compulsive disorder: a meta-analysis of randomised controlled trials. International journal of psychiatry in clinical practice 2025. link
2 Vinod P, Thatikonda NS, Malo PK, Bhaskarapillai B, Arumugham SS, Janardhan Reddy YC. Comparative efficacy of repetitive transcranial magnetic stimulation protocols for obsessive-compulsive disorder: A network meta-analysis. Asian journal of psychiatry 2024. link
3 Zisler EM, Meule A, Endres D, Schennach R, Jelinek L, Voderholzer U. Effects of inpatient, residential, and day-patient treatment on obsessive-compulsive symptoms in persons with obsessive-compulsive disorder: A systematic review and meta-analysis. Journal of psychiatric research 2024. link
4 Rowe C, Deledalle A, Boudoukha AH. Psychiatric comorbidities of obsessive-compulsive disorder: A series of systematic reviews and meta-analyses. Journal of clinical psychology 2022. link
5 Song Y, Li D, Zhang S, Jin Z, Zhen Y, Su Y et al.. The effect of exposure and response prevention therapy on obsessive-compulsive disorder: A systematic review and meta-analysis. Psychiatry research 2022. link
6 Cruz S, Gutiérrez-Rojas L, González-Domenech P, Díaz-Atienza F, Martínez-Ortega JM, Jiménez-Fernández S. Deep brain stimulation in obsessive-compulsive disorder: Results from meta-analysis. Psychiatry research 2022. link