Obsessive Compulsive Disorder
- Epidemiology
- Comorbidity
- OCD and Tic Disorder
- OCD and Depression
- OCD and Other Anxiety Disorders
- OCD and Phobia
- OCD and OCPD
- OCD and Schizophrenia
- Course and Prognosis
- Etiology
- Specific Clinical Response
- Serotonin Antagonists
- Pharmacological Challenges
- Dopamine
- Immune Factors
- Brain Imaging Studies
- Genetics
- Other Biological Data
- Behavioral Factors
- Psychosocial Factors
- Treatment of OCD
- Efficacy of Serotonergic vs Adrenergic Antidepressants
- Long Term Treatment of OCD
- Drug Dosage
- Psychological Approaches
- Treatment Resistant OCD
- Switching Medications
- Augmentation
- Risperidone
- Pindolol
- Other Options
- Intravenous Clomipramine
- Monoamine Oxidase Inhibitors
- Last-line Therapies
Course and Prognosis for OCD
OCD is characterized by a slow onset of symptoms and it may take years for symptoms to become full-blown. However, a rapid onset of symptoms may occur, sometimes associated with a traumatic event, such as pregnancy or loss. Due to the secretive nature of the disorder, there is often a delay of more than 10 years before patients come to psychiatric attention . However, this delay may be shortened by the increasing public awareness regarding the disorder, through a proliferation of articles, books and movies on the subject. The course is usually long, with most patients experiencing a chronic course, while others experience a fluctuating one .
A poor prognosis is indicated by yielding to (rather than resisting) compulsions. Further indications include childhood onset, bizarre compulsions, the need for hospitalization, coexisting MDD, delusional beliefs, the presence of overvalued ideas (that is, some acceptance of the obsessions and compulsions), and the presence of a personality disorder (especially schizotypal personality disorder). A good prognosis is indicated by good social and occupational adjustment, the presence of a precipitating event, and an episodic nature to the symptoms. Obsessional content does not appear to be related to prognosis. However, further research is needed in order to examine the nature and determinants of prognosis in OCD.