Management of obsessive-compulsive disorder in adults

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.