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
OCD and Depression
Depression is the most common complication of OCD and by recognizing this relationship, DSM-IV no longer excludes a diagnosis ofOCDif depression is present. Instead, it stipulates that the obsession may not be related in content to the guiltridden rumination of major depression. However, a precise definition of the relationship between OCD and depression remains elusive. At the clinical level, the illnesses often seem inseparable—one worsening or improving in synchrony with the other.
However, in other clinical cases, OCD symptoms may remain in remission while depression recurs. Although researchers have reported some similarities in the biological markers for depression and OCD, the differences between the two outweigh their similarities . The most striking difference is that antidepressants with excellent efficacy, such as the noradrenergic re-uptake inhibitor desipramine, appear to be totally ineffective in the treatment of OCD . Only medications possessing serotonergic properties, such as clomipramine, fluoxetine, fluvoxamine, paroxetine, sertraline and citalopram, have consistent efficacy in reducing OCD symptoms. Other differences relate again to the lack of therapeutic effect of electroconvulsive therapy (ECT) or lithium augmentation in OCD, as compared with their proven efficacy in depression.