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Review
. 2025 Oct:177:106320.
doi: 10.1016/j.neubiorev.2025.106320. Epub 2025 Aug 22.

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

Dominique Endres  1 , Miriam A Schiele  2 , Katharina von Zedtwitz  2 , Raphael J Dressle  2 , Alexander Maier  2 , Fritz Hohagen  3 , Juan C Baldermann  4 , Volker A Coenen  5 , Lena Jelinek  6 , Katharina Domschke  7 , Ulrich Voderholzer  8
Affiliations
Review

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

Dominique Endres et al. Neurosci Biobehav Rev. 2025 Oct.

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.

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Conflict of interest statement

Declaration of Competing Interest KD: Member of the Neurotorium Editorial Board, The Lundbeck Foundation. She received speaker’s honoraria by Janssen-Cilag GmbH. VAC: He receives a collaborative grant from BrainLab (Munich, Germany); he is a consultant for Ceregate (Munich, Germany), Cortec (Freiburg, Germany), and Inbrain (Barcelona, Spain); he has an ongoing IIT with Boston Scientific (USA) and has received personal honoraria and travel support for lecture work from Boston Scientific (USA), and ALEVA. All other authors declare no potential conflicts of interest.

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