[Neurological soft signs in patients with obsessive compulsive disorder]

Background Obsessive-compulsive disorder (OCD) is a psychiatric condition with a lifetime prevalence of 2-3% and was long classified as an anxiety disorder but has been considered a separate condition since DSM-5. An imbalance between cortical and subcortical structures seems to be at the pathophysiological basis of the disorder.

To review the presence, diagnostic and therapeutic importance of neurological soft signs (NSS), as a sign of network dysfunction in obsessive-compulsive disorder.

Literature review regarding the occurrence of NSS in OCD. PubMed, Ovid Medline and PsycArticles were consulted for this purpose with the advanced search (((OCD) AND (neurological soft signs)) OR (obsessive compulsive disorder)) AND (neurological soft signs).

Our literature search yielded 27 articles that showed a higher NSS score in a patient group with OCD than in healthy controls. First-degree relatives achieve an NSS score intermediate between the two groups. NSS are also found in other psychiatric syndromes e.g., NSS score is higher in patients with schizophrenia or comorbid psychotic problems compared to the OCD patient group.

These findings show the importance of neurological examination and documentation of abnormalities in OCD patients, for now the applicability of these neurological signs remains limited in diagnostics and treatment of OCD.