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Natural History and Long-Term Outcome of OCD 

Natural History and Long-Term Outcome of OCD
Chapter:
Natural History and Long-Term Outcome of OCD
Author(s):

Michael H. Bloch

DOI:
10.1093/med/9780190228163.003.0005
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date: 26 June 2022

Obsessive-compulsive disorder (OCD) is often a chronic condition. Convergent evidence suggests that early-onset and adult-onset disease are importantly distinct: early-onset OCD is more highly genetic, has a male bias, and is more often associated with tic disorders and attention deficit disorder. Adult-onset OCD has an equal male–female ratio and is more often associated with anxiety and depression. Long-term follow-up studies from before institution of effective treatments suggest that a minority of individuals with adult-onset OCD remit, and many have persistent severe symptoms. There are few analogous studies of patients with childhood-onset OCD. Prognosis has improved over the past 30 years with the development of effective, evidence-based pharmacotherapy and psychotherapies. More recent long-term follow-up studies of both adult-onset and pediatric-onset OCD suggest remission rates of up to 50%. Refractory illness nevertheless remains an important clinical problem.

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