Obsessive-compulsive disorder - A state-of-the-art review

Dominique Endres; Miriam A Schiele; Katharina von Zedtwitz; Raphael J Dressle; Alexander Maier; Fritz Hohagen; Juan C Baldermann; Volker A Coenen; Lena Jelinek; Katharina Domschke; Ulrich Voderholzer

doi:10.1016/j.neubiorev.2025.106320

Obsessive-compulsive disorder - A state-of-the-art review

Neurosci Biobehav Rev. 2025 Oct:177:106320. doi: 10.1016/j.neubiorev.2025.106320. Epub 2025 Aug 22.

Affiliations

¹ Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Electronic address: dominique.endres@uniklinik-freiburg.de.
² Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
³ Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany.
⁴ Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
⁵ Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Deep Brain Stimulation, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁷ Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Center for Mental Health (DZPG), Partner Site Berlin/Potsdam, Berlin, Germany.
⁸ Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany.

PMID: 40850533
DOI: 10.1016/j.neubiorev.2025.106320

Abstract

Obsessive-compulsive disorder (OCD) is a severe and common mental illness associated with high rates of treatment resistance. Quality of life is significantly impaired by OCD, and there is a high risk of chronification without treatment. The rationale of this narrative review is to present the state of the art about OCD regarding its A) relevance, course, and impact on wellbeing, B) risk factors, C) etiopathophysiology, D) clinical manifestation and classification criteria, E) comorbidity and differential diagnostics, F) diagnostic investigations, G) secondary obsessive-compulsive syndromes, and H) treatment approaches. Finally, the consequences of novel developments for the diagnosis and treatment of individual patients are summarized, and the needs for further research are outlined.

Keywords: Brain; Exposure and response prevention; ICD-11; OCD; Precision medicine; SSRI.

Publication types

Review

MeSH terms

Comorbidity
Humans
Obsessive-Compulsive Disorder* / diagnosis
Obsessive-Compulsive Disorder* / epidemiology
Obsessive-Compulsive Disorder* / physiopathology
Obsessive-Compulsive Disorder* / therapy
Quality of Life
Risk Factors