ABSTRACT
University of Michigan Medical Center Obsessive-compulsive disorder (OCD) is characterized by recurrent and persistent thoughts that are experienced as intrusive and inappropriate and that cause marked distress, and by repetitive behaviors or mental acts that are aimed at reducing distress or preventing a dreaded event (American Psychiatric Association, 1994). The phenomenologic description of OCD has remained stable over the past century. The case descriptions of Janet (1908) and others seem remarkably consistent with the clinical picture seen today (Pitman, 1987). Furthermore, its presentation appears similar across cultures (Honjo et al., 1989; Thomsen, 1991). In contrast to other forms of severe psychopathology, the symptoms of OCD are virtually identical in children and adults (Fischer, Himle, & Hanna, 1997; Hanna, 1995a). Although a majority of OCD patients respond to treatment, most of those who improve significantly are left with residual symptoms and about 30% are treatment refractory (Rasmussen, 1996). More effective treatments may result from current studies of genetic and environmental factors in the etiology of OCD.
