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Obsessive Compulsive Disorder: Clinical Advances and Future Perspectives
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Obsessive Compulsive Disorder: Clinical Advances and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 20 September 2025 | Viewed by 3725

Special Issue Editor

Prof. Dr. Andrea Fagiolini

E-Mail Website
Guest Editor
Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, 53100 Siena, Italy
Interests: mood; anxiety; psychotic disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obsessive compulsive disorder (OCD) is a complex and often debilitating mental disorder characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) performed to relieve distress. Despite significant advances in the understanding of OCD, many aspects of its etiology, pathophysiology, and treatment remain unclear. This Special Issue aims to consolidate the latest research and clinical findings on OCD and to promote a comprehensive understanding of the disorder.

We invite contributions that explore neurobiological underpinnings, genetic and environmental influences, and innovative therapeutic interventions. In addition, we welcome studies on the impact of comorbid conditions, advances in diagnostic criteria, and the development of novel treatment modalities.

A major focus of this Special Issue will be on personalized treatment pathways for OCD, emphasizing the progression from initial treatment strategies to the management of the most resistant presentations of the disorder. We seek research on tailored therapeutic approaches, including cognitive–behavioral therapy (CBT), pharmacotherapy, and emerging treatments such as neuromodulation techniques. Papers that discuss treatment selection criteria, strategies for improving treatment adherence, and methods for optimizing outcomes in resistant-OCD cases are particularly encouraged.

We also encourage submissions that explore the phenomenology of OCD, examining the diverse manifestations and subjective experiences of the disorder. Understanding the different ways in which OCD presents and affects individuals may lead to more effective and empathetic treatment approaches.

In addition, this Special Issue invites research on the application of artificial intelligence (AI) to the study and treatment of OCD. We are interested in how AI can be used to analyze large datasets to gain new insights into the disorder, predict treatment response, and help select the most effective interventions for individual patients. Papers discussing AI-driven diagnostic tools, personalized treatment algorithms, and predictive models of treatment outcomes are highly encouraged.

By bringing together a diverse range of high-quality research works, this Special Issue aims to advance our knowledge of OCD, promote evidence-based practice, and ultimately improve outcomes for individuals affected by this challenging disorder.

Prof. Dr. Andrea Fagiolini
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • obsessions–compulsions
  • anxiety
  • OCD symptoms
  • treatment options
  • functional impairment

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Published Papers (3 papers)

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Research

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18 pages, 1232 KiB  
Article
Obsessive–Compulsive Disorder with a Religious Focus: An Observational Study
by Wissam Al Rida Ayoub, Jana Dib El Jalbout, Nancy Maalouf, Samar S. Ayache, Moussa A. Chalah and Ronza Abdel Rassoul
J. Clin. Med. 2024, 13(24), 7575; https://doi.org/10.3390/jcm13247575 - 12 Dec 2024
Viewed by 1684
Abstract
Background: Obsessive–compulsive disorder (OCD) is a psychiatric disorder with poorly detailed subtypes/dimensions, such as religious OCD (ROCD). To date, little is known about ROCD characteristics. This work aimed to describe the sociodemographic and clinical characteristics, along with the religiosity and spirituality, of [...] Read more.
Background: Obsessive–compulsive disorder (OCD) is a psychiatric disorder with poorly detailed subtypes/dimensions, such as religious OCD (ROCD). To date, little is known about ROCD characteristics. This work aimed to describe the sociodemographic and clinical characteristics, along with the religiosity and spirituality, of Lebanese Muslim citizens diagnosed with OCD and exhibiting religious symptoms. Methods: Participants were Lebanese Muslims, outpatients with OCD and religious symptoms, aged 18 or above, who could complete a questionnaire. Exclusion criteria were as follows: other psychiatric disorders and cognitive or physical impairments preventing participation. They completed a questionnaire including the 25-item Arabic Scale of Obsessions and Compulsions (10 questions addressing obsessions, 10 questions addressing compulsions, and 5 filler items, all of which were rated on a 4–point Likert scale, with higher total scores indicating increasing severity), the 26-item Spiritual Involvement and Beliefs Scale (rated on a 5-point Likert scale, with higher scores indicating higher spirituality), and questions assessing sociodemographic, clinical, and religiosity variables. Results: Fifty adults (62% females, 52% aged between 18 and 29 years) completed the study. They had mild (26%), moderate (48%), and severe (26%) OCD symptoms. The majority attended religious school at least at one point in their life and described a moderate to very high degree of self-religiosity and parental religiosity. Group comparisons (patients with mild vs. moderate vs. severe OCD symptoms) showed significant differences with regard to a family history of psychiatric disorders (p = 0.043), the frequency of self-questioning if they prayed correctly (p = 0.005), a higher rating of partial ablution repetition (p = 0.006), and the frequency of partial ablution repetitions (p = 0.041). No significant group differences were noted with regard to sociodemographic or spirituality outcomes. The prevalence of religious doubts (i.e., self-questioning if praying correctly) and specific rituals (partial ablution repetition) among severe OCD patients were 100% (13/13) and 77% (10/13), respectively. Conclusions: The results suggest a link between specific religious practices and OCD severity, underscoring the need for culturally sensitive approaches in diagnosing and treating ROCD. Full article
(This article belongs to the Special Issue Obsessive Compulsive Disorder: Clinical Advances and Future Perspectives)
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11 pages, 412 KiB  
Article
Assessing the Pharmacotherapy and Clinical Outcomes After Deep Brain Stimulation for Treatment-Refractory Obsessive–Compulsive Disorder: A Case–Cohort Study
by Joshua Knebel, Robert K. McClure and M. Lindsey Hedgepeth Kennedy
J. Clin. Med. 2024, 13(21), 6549; https://doi.org/10.3390/jcm13216549 - 31 Oct 2024
Viewed by 1221
Abstract
Background: In the search for effective treatments for refractive obsessive–compulsive disorder (OCD), deep brain stimulation (DBS) serves as an alternative option for those with minimal response to pharmacotherapy. The rarity of reports regarding DBS use for OCD is attributed to the invasive nature [...] Read more.
Background: In the search for effective treatments for refractive obsessive–compulsive disorder (OCD), deep brain stimulation (DBS) serves as an alternative option for those with minimal response to pharmacotherapy. The rarity of reports regarding DBS use for OCD is attributed to the invasive nature of the procedure: placement of electrodes within targeted areas of the brain to provide neuromodulation. This treatment of last resort may decrease functional impairment and pharmacologic complications for a debilitating mental illness. This study compares the pharmacotherapy utilization and treatment outcomes of five treatment-refractory OCD patients after the placement of DBS with those of a matched cohort. Methods: This retrospective, single-center, case–cohort study reviewed the electronic medical records of five subjects treated with DBS for treatment-refractory OCD and compared them to a similar treatment-refractory cohort whose OCD was treated without the use of DBS. Control subjects were matched by age, sex, years since diagnosis, number of previous medication class trials, and additional clinical factors. Inclusion criteria were defined as those that are at least eighteen years of age, assigned a primary diagnosis of OCD per the ICD-10 classification, and received DBS treatment for refractory OCD. Exclusion criteria included comorbid psychotic disorders, unstable neurological or coagulation disorder(s), and/or an eating disorder diagnosis. The primary endpoint was the change in the number of psychotropic medications two years after implantation for the DBS cohort and two years after psychiatric decompensation for the comparator cohort. Secondary endpoints included: Y-BOCS (the Yale–Brown Obsessive–Compulsive Scale) changes over time, duration quantity of psychotropic medication classes prescribed, and additional symptomology scale changes. Results: Patients receiving DBS were more likely to be on fewer medications and trialed fewer medications after treatment. One out of the five patients was found to be a responder in Y-BOCS scoring after DBS treatment. A reduction in anxiety and depression symptoms was also seen in the HAM-A and HAM-D scales for those that received DBS. Conclusions: A reduction in psychiatric medications trialed during therapy was observed, as well as varying reductions in OCD, anxiety, and depression symptomology following DBS. Results from this study indicate that DBS implantation may contribute to a reduction in polypharmacy while displaying DBS’s potential impact on comorbid anxiety and depression symptoms. Given that the small sample size limits generalizability, additional prospective, randomized trials comparing the efficacy of DBS for OCD-specific symptomology and its overall impact on pharmacotherapy are needed in order to further establish the role of DBS as an accepted treatment option for OCD. Full article
(This article belongs to the Special Issue Obsessive Compulsive Disorder: Clinical Advances and Future Perspectives)
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Review

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17 pages, 2057 KiB  
Review
Precision Psychiatry for Obsessive-Compulsive Disorder: Clinical Applications of Deep Learning Architectures
by Brian A. Zaboski and Lora Bednarek
J. Clin. Med. 2025, 14(7), 2442; https://doi.org/10.3390/jcm14072442 - 3 Apr 2025
Viewed by 457
Abstract
Obsessive-compulsive disorder (OCD) is a complex psychiatric condition characterized by significant heterogeneity in symptomatology and treatment response. Advances in neuroimaging, EEG, and other multimodal datasets have created opportunities to identify biomarkers and predict outcomes, yet traditional statistical methods often fall short in analyzing [...] Read more.
Obsessive-compulsive disorder (OCD) is a complex psychiatric condition characterized by significant heterogeneity in symptomatology and treatment response. Advances in neuroimaging, EEG, and other multimodal datasets have created opportunities to identify biomarkers and predict outcomes, yet traditional statistical methods often fall short in analyzing such high-dimensional data. Deep learning (DL) offers powerful tools for addressing these challenges by leveraging architectures capable of classification, prediction, and data generation. This brief review provides an overview of five key DL architectures—feedforward neural networks, convolutional neural networks, recurrent neural networks, generative adversarial networks, and transformers—and their applications in OCD research and clinical practice. We highlight how these models have been used to identify the neural predictors of treatment response, diagnose and classify OCD, and advance precision psychiatry. We conclude by discussing the clinical implementation of DL, summarizing its advances and promises in OCD, and underscoring key challenges for the field. Full article
(This article belongs to the Special Issue Obsessive Compulsive Disorder: Clinical Advances and Future Perspectives)
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