Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) is a psychiatric disorder hallmarked by intrusive obsessive thoughts  creating uneasiness, apprehension, fear, or worry, combined with compulsive, repetitive actions meant to reduce the anxiety. Feeling driven to actions that they realize are irrational can cause patients shame, alienation and isolation, as well as taking time away from more normal everyday activities. OCD affects about 1 percent of the adult population. It is believed to have a neurobiological basis. Brain scans show people with OCD have different patterns of brain activity than people without it.

Behavioral therapy, cognitive behavioral therapy, and medication are first-line treatments.

Intractable OCD, that has not improved with at least five years of aggressive treatment, may be considered for treatment with deep brain stimulation. In 2009, the U.S. FDA issued a humanitarian use exemption for this application, which is an extension of neurostimulator implant treatment used by some Parkinson’s patients to control tremor and motor symptoms of their disease. Deep brain stimulation remains investigational for OCD patients and is not considered standard therapy. It is believed deep brain stimulation may restore balance to dysfunctional brain circuitry implicated in OCD. Although the patient base is small, published reports indicate deep brain stimulation can reduce severe OCD symptoms in many cases.

Reviewed April 2, 2012
Jaimie Henderson, MD
Director-at-Large, International Neuromodulation Society, 2011-2014
Director, Stereotactic and Functional Neurosurgery; Associate Professor, Neurosurgery; Associate Professor, Neurology & Neurological Sciences, Stanford University Medical Center, Stanford, CA, USA

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