SAIMSARA Journal

Machine Generated Science • ISSN 3054-3991

Obsessive-Compulsive Disorder: Scoping Review with ☸️SAIMSARA.

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• Last update: 2026-04-01 21:26:53
What is this paper about
This paper shows that OCD is not one single disease pattern, but a heterogeneous disorder shaped by brain-circuit dysfunction, comorbidity, and symptom subtype. The full read is worth it because it clarifies which treatments have the strongest evidence, which patients are harder to treat, and why long-term outcome may be better than many assume.

DOI: 10.62487/saimsara99e2ed0c

Abstract: To synthesize a comprehensive overview of obsessive-compulsive disorder (OCD) by examining its pathophysiological foundations, clinical heterogeneity, comorbid associations, and the efficacy of diverse pharmacological and psychological interventions across different patient populations. The review utilises 408 original studies with 188469 total participants (topic deduplicated ΣN). This evidence map suggests that OCD is best understood as a heterogeneous disorder with a prominent neurocircuitry signal centered on CSTC dysfunction, while long-term outcome is not uniformly poor, with one cohort indicating about 60% remission over 30 years. Therapeutically, the clearest recurrent signals favored serotonergic treatment and ERP/CBT, including clomipramine superiority to placebo, fluvoxamine benefit with 81% versus 19% improvement in one trial, and comparable 2-year pediatric response rates for stepped-care versus in-person CBT of 66% and 71%. At the same time, the mapped literature consistently highlights that prognosis and treatment response are shaped by comorbidity and subtype, including depression, psychosis-spectrum features, ASD, tic-related presentations, poor insight, and family accommodation. Clinically, this supports careful differential diagnosis, routine assessment of comorbid burden, and stepped escalation from first-line SSRI/ERP approaches to augmentation or neuromodulation in refractory cases. Future research should prioritize larger longitudinal and subtype-stratified studies that integrate circuit, cognitive, and comorbidity markers to clarify which patients benefit most from specific pharmacologic, psychotherapeutic, and neuromodulatory interventions.

Keywords: Functional connectivity; Psychiatric comorbidity; Symptom dimensions; Autism spectrum disorder; Cortico-striato-thalamo-cortical loop; Cognitive behavioral therapy; Pharmacotherapy; Neurobiology; Suicidal behavior; Clinical remission

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