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Management of obsessive-compulsive disorder in adults

Jonathan S Abramowitz, Amitai Abramovitch, Dean Mckay, Alyssa Draffin

BMJ February 16, 2026 DOI: 10.1136/bmj-2024-083443 via OpenAlex

Summary

AI-generated from the abstract

Obsessive-compulsive disorder (OCD) is a chronic condition marked by intrusive thoughts and rituals. While exposure and response prevention (ERP) is the first-line treatment, many patients do not fully recover, prompting a need for innovation. This review synthesizes evidence-based treatments for OCD in adults, covering established psychological and pharmacological therapies and recent findings on treatment outcomes. It examines emerging approaches, including inhibitory-learning-informed ERP, acceptance and commitment therapy, inference-based therapy, telehealth delivery, and biological treatments such as psilocybin, ketamine, and neuromodulation. Cultural and identity-related considerations are discussed, emphasizing tailored interventions for diverse populations.

Study at a glance

Characteristics Review Peer reviewed
Population Adults with obsessive-compulsive disorder
Keywords Psychological intervention Telehealth Neuromodulation Psychological therapy Medline
Citations 1
Key finding Despite ERP being the first-line treatment, many individuals with OCD do not experience full remission, driving innovation in psychological and biological therapies.

Abstract

Obsessive-compulsive disorder (OCD) is a chronic, often debilitating psychiatric condition characterized by intrusive thoughts and behavioral or mental rituals. Although exposure and response prevention (ERP) remains the first line treatment, many individuals do not experience full remission, highlighting the need for innovation. This review provides a comprehensive and up-to-date synthesis of evidence based treatments for OCD in adults, as well as emerging psychological and biological approaches. It first describes established psychological and pharmacological therapies, highlighting recent findings and factors affecting treatment outcomes. It then examines innovations in psychological care including inhibitory learning informed ERP, acceptance and commitment therapy, inference based therapy, and telehealth delivery methods, as well as emerging biological treatments such as psilocybin, ketamine, and neuromodulation techniques. Cultural and identity related considerations are also discussed, emphasizing the importance of tailoring interventions for diverse populations.

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