Clinical presentations and treatment outcomes between bi+, gay/lesbian, and heterosexual adults with obsessive-compulsive disorder

Sexual minority people are at increased risk of psychopathology, including obsessive-compulsive disorder (OCD), compared with heterosexual people. Prior research has found that sexual minority people are more likely to be diagnosed with or treated for OCD compared with their heterosexual peers, and sexual minority people represent a substantial portion of those in OCD treatment. As such, it is critical to examine potential sexual orientation differences in clinical presentation and treatment outcomes among people with OCD. Among 437 patients in treatment for OCD, we examined OCD severity and related constructs (depression, worry, and quality of life) over treatment as a function of sexual orientation (bi+, gay/lesbian, and heterosexual). At admission, there were no significant differences in clinical presentation between bi+, gay/lesbian, and heterosexual people. Treatment resulted in significantly reduced symptoms across all groups. However, depression was more severe across treatment for bi+ versus heterosexual people, improvements in quality of life were quicker for heterosexual and bi+ versus gay/lesbian people, and bi+ people reported quicker improvements in OCD versus heterosexual people. Clinical implications are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).