Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What happens if OCD is not treated? What are complications of obsessive compulsive disorder?
Without treatment, the symptoms of OCD can progress to the point that the
sufferer's life becomes consumed, inhibiting their ability to attend school, keep a job, and/or
maintain important relationships. Many people with OCD have thoughts of killing
themselves, and about 1% complete suicide.
In terms of the prognosis for the specific symptoms, it is rare for any to
progress to a physically debilitating level. However, problems like compulsive
hand washing can eventually cause complications like the skin becoming dry and even breaking down.
Repeated trichotillomania can result in unsightly scabs on the
What is the prognosis for OCD?
While in about 40% of people diagnosed with OCD the symptoms tend to persist indefinitely to some degree,
most are only mildly to moderately affected by those symptoms if adequately
treated. People who have the symptoms of OCD longer before being diagnosed
and treated are both at higher risk of having more severe OCD and of developing other mental health illnesses in the future.
How is OCD prevented?
OCD is best prevented through early recognition and treatment. Specifically, recognizing warning signs that a child may be at risk for developing OCD can be a place to start. Examples of such early warning signs include excessive complaints (hypersensitivity) by the child that certain clothes or food textures are intolerable, as well as a child who engages in rigid patterns of behavior.
Where can I get more information about obsessive compulsive disorder?
Further information about OCD can be gained from the following resources.
American Psychiatric Association. Diagnostic Criteria from Diagnostic and
Statistical Manual, Fourth Edition, Treatment Revision 2000.
American Psychiatric Association. Treatment of patients with obsessive-compulsive disorder. Practice Guidelines 2007 July.
Amiaz, R., L. Fostick, A. Gershon, and J. Zohar. "Naltrexone Augmentation in OCD: A Double-Blind Placebo-Controlled Cross-over Study." European Neuropsychopharmacology
18.6 June 2008: 455-461.
Awareness Foundation for OCD and Related Disorders. Mental health and OCD
Bejerot, S., L. Ekselius, and L. von Knorring. "Comorbidity Between
Obsessive-Compulsive Disorder (OCD) and Personality Disorders." Acta Psychiatry
Scandinavia 97.6 (1998): 398-402.
Caspi, A., T. Vishne, Y. Sasson, et al. "Relationship Between Childhood Sexual
Abuse and Obsessive-Compulsive Disorder: Case Control Study." Israeli Journal of Psychiatry and Related Sciences
45.3 (2008): 177-182.
Chabane, N., R. Delorme, B. Millet, M.C. Mouren, M. Lebover, and D. Pauls. "Early-Onset
Obsessive-Compulsive Disorder: A Subgroup With a Specific Clinical and Familial
Pattern?" Journal of Child Psychology and Psychiatry 46.8 (2004): 881-887.
Cordioli, A.V., E. Heldt, D.B. Bochi, R. Maris, M.B. de Sousa, J.F. Tonello, et
al. "Cognitive-Behavioral Group Therapy in Obsessive-Compulsive
Disorder: A Randomized Clinical Trial." Psychotherapy and Psychosomatics
72 (2003): 211-216.
Dar, R., D.T. Kahn, and R. Carmeli. "The relationship between sensory processing, childhood rituals and obsessive-compulsive symptoms." Journal of Behavioral Therapy and Experimental Psychiatry 43.1 Sept. 2011: 679-684.
Foa, E.B., M.R. Liebowitz, M.J. Kozak, et al. "Randomized,
Placebo-Controlled Trial of Exposure and Ritual Prevention, Clomipramine and
Their Combination in the Treatment of Obsessive-Compulsive Disorder." Focus 5
Summer 2007: 368-380.
Geller, D.A., J. Biederman, S.E. Stewart, et al.
"Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric
Obsessive-Compulsive Disorder." American Journal of Psychiatry 160 (2003):
Goodman, W.K., K.D. Footec, B.D. Greenberg, et al. "Deep Brain Stimulation for
Intractable Obsessive Compulsive Disorder: Pilot Study Using a Blinded, Staggered-Onset
Design." Biological Psychiatry 67.6 Mar. 2010: 535-542.
Heyman, I., D. Mataix-Cols, and N.A. Fineber. "Obsessive-Compulsive Disorder."
British Medical Journal 333 Aug. 2006: 424-429.
Horwath, E., and M. Weissman. "The Epidemiology and Cross-National Presentation of
Obsessive-Compulsive Disorder." Psychiatric Clinics of North America 23.3
Hu, X.Z., R.H. Lipsky, G. Zhu, et al. "Serotonin Transporter Promoter Gain-of-Function
Genotypes Are Linked to Obsessive-Compulsive Disorder." American Journal of Human
Genetics 78.5 May 2006: 815-826.
Journal of the American Medical Association. Obsessive compulsive disorder.
Kobak, K.A., J.H. Greist, J.W. Jefferson, et al. "Behavioral Versus
Pharmacological Treatments of Obsessive Compulsive Disorder." Focus 2 (2004):
Micali, N., I. Heyman, M. Perez, et al. "Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents." British Journal of Psychiatry 197 (2010): 128-134.
National Institute of Mental Health. The numbers count: Mental disorders in
America. June 26, 2008.
National Institute of Mental Health. Psychotherapy, medications best for youth
with obsessive compulsive disorder. Press Release. Oct. 28, 2004.
Pallanti, S. "Transcultural Observations of Obsessive-Compulsive Disorder."
American Journal of Psychiatry 165 (2008): 169-170.
Saxena, S. "Is Compulsive Hoarding a Genetically and Neurobiologically Discrete
Syndrome? Implications for Diagnostic Classification." American Journal of Psychiatry
164 Mar. 2007: 380-384.
Sessa, B. "Can Psychedelics Have a Role in Psychiatry Once Again?" The British Journal of Psychiatry
186 (2005): 457-458.
Simon, N.M., M.W. Otto, S.R. Wisniewski, M. Fossey, M., et al. "Anxiety Disorder Comorbidity in
Bipolar Disorder Patients: Data From the First 500 Participants in the Systematic
Treatment Enhancement Program for Bipolar Disorder (STEP-BD)." American Journal of Psychiatry
161 Dec. 2004: 2222-2229.
Storch, E.A., L.J. Merlo, M.L. Keeley, et al. "Somatic symptoms in children and adolescents with obsessive-compulsive disorder: associations with clinical characteristics and cognitive-behavioral therapy response." Behavioural and Cognitive Psychotherapy 36 (2008): 283-297.
Reviewed by Melissa Conrad Stöppler, MD on 10/3/2012