New developments in obsessive-compulsive disorder research: implications for clinical management.

Over the past decade, epidemiological, phenomenological, pharmacological, neurobiological, brain imaging and genetic research has contributed to a substantial change in our understanding of obsessive-compulsive disorder (OCD). Once regarded as a rare psychodynamic illness, OCD is now recognized as a common condition affecting 2-3% of the population. Better recognition combined with the demonstrated efficacy of serotonin reuptake inhibitors, such as clomipramine and the selective serotonin reuptake inhibitors (SSRIs), has dramatically improved the prognosis of this disorder, which exacts a considerable personal and economic burden. While the aetiology is still not understood, increasingly sophisticated research techniques are enabling us to begin to uncover the underlying pathophysiology of this illness. This paper reviews some of the recent developments which have enhanced our understanding of OCD and considers their potential impact on clinical management.