# Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder characterized by uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that people feel the urge to repeat over and over. Symptoms can fluctuate over time, and people with OCD may try to help themselves by avoiding situations that trigger their obsessions. OCD is a common disorder that affects adults, adolescents, and children, and most people with the disorder are diagnosed by early adulthood. Learn more about obsessive-compulsive disorder (OCD).

## Featured Studies

Featured studies include only those **currently recruiting participants**. Studies with the most recent start date appear first.

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### Examining Mu Opioid Mechanisms of Ketamine's Rapid Effects in OCD (MKET2) **

**Study Type:** Interventional**Start Date:** February 24, 2024**Eligibility:** 18 Years to 65 Years, Accepts Healthy Volunteers**Location(s):** Department of Psychiatry & Behavioral Sciences, Stanford, California, United States    

The purpose of this study is to understand how ketamine works in the brain to bring about a reduction in OCD symptoms.

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### A Precision Medicine Approach to Target Engagement for Emotion Regulation **

**Study Type:** Interventional**Start Date:** September 29, 2023**Eligibility:** 18 Years and Older, Does Not Accept Healthy Volunteers**Location(s):** University of Kentucky, Lexington, Kentucky, United States    

The proposed study is designed to first test whether teaching people personalized or standardized emotion regulation skills leads to greater decreases in daily negative emotion intensity. Second, using data from an initial sample, the investigators will prospectively assign an independent sample of participants to receive their predicted optimal or non-optimal skills to determine if it is feasible and efficacious to match participants to the most appropriate training condition. Results of these studies may identify the mechanisms by which emotion regulation interventions impact emotional functioning and allow for the development of personalized, evidence-based, and scalable emotion regulation interventions.

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### Neurostimulation Versus Therapy for Problems With Emotions **

**Study Type:** Interventional**Start Date:** May 15, 2023**Eligibility:** 18 Years to 55 Years, Does Not Accept Healthy Volunteers**Location(s):** Duke University Medical Center, Durham, North Carolina, United States    

The primary goal of this clinical trial is to evaluate the unique neural and behavioral effects of a one-session training combining emotion regulation skills training, with excitatory repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (dlPFC). The secondary aim is to identify key changes in the emotion regulation neural network following the combined intervention versus each of the components alone. The third aim is to explore personalized biomarkers for response to emotion regulation training.

Participants will undergo brain imaging while engaging in an emotional regulation task. Participants will be randomly assigned to learn one of two emotion regulation skills. Participants will be reminded of recent stressors and will undergo different types of neurostimulation, targeted using fMRI (functional MRI) results. Participants who may practice their emotion regulation skills during neurostimulation in a one-time session. Following this training, participants will undergo another fMRI and an exit interview to assess for immediate neural and behavioral changes. Measures of emotion regulation will be assessed at a one week and a one month follow up visit.

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### CO2 Reactivity as a Biomarker of Non-Response to Exposure-Based Therapy **

**Study Type:** Interventional**Start Date:** November 2, 2022**Eligibility:** 18 Years to 70 Years, Does Not Accept Healthy Volunteers**Location(s):** Boston University, Boston, Massachusetts, United States; The University of Texas at Austin, Austin, Texas, United States    

Anxiety-, obsessive-compulsive and trauma- and stressor-related disorders reflect a significant public health problem. This study is designed to evaluate the predictive power of a novel biomarker based on a CO2 challenge, thus addressing the central question "can this easy-to-administer assay aid clinicians in deciding whether or not to initiate exposure-based therapy?"

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### Computerized Intervention Targeting the Error-Related Negativity and Balance N1 in Anxious Children **

**Study Type:** Interventional**Start Date:** October 12, 2022**Eligibility:** 9 Years to 12 Years, Accepts Healthy Volunteers**Location(s):** FSU Psychology Building, Tallahassee, Florida, United States    

Anxiety disorders are the most common form of psychopathology, and frequently begin in childhood, resulting in lifelong impairment. Increased brain activity after making mistakes, as reflected by the error-related negativity (ERN), is observed in people with anxiety disorders, even before disorder onset. The ERN is therefore of great interest as a potentially modifiable risk factor for anxiety. However, methodological issues can make the ERN difficult to measure.

Increased brain activity in response to a balance disturbance, as reflected by the balance N1, resembles the ERN, but does not share its methodological issues. The investigators' preliminary data demonstrate that the balance N1 and the ERN are associated in amplitude in adults, suggesting they may depend on the same brain processes. The balance N1 has never been investigated in individuals with anxiety disorders, but it increases in amplitude within individuals under anxiety-inducing environmental contexts. Further, balance and anxiety are related in terms of brain anatomy, daily behavior, disorder presentation, and response to treatment.

The present investigation will measure the ERN and the balance N1 in children (ages 9-12) with anxiety disorders, and further, how these brain activity measures change in response to a brief, 45-minute, computerized psychosocial intervention that was developed to reduce reactivity to errors, and has been shown to reduce the ERN. The investigators will recruit approximately 80 children with anxiety disorders, half of whom will be randomly assigned to the active intervention condition. The other half will be assigned to an active control condition, consisting of a different 45-minute computerized presentation. Participants assigned to the control condition can access the computerized intervention after participation in the study.

The purpose of this investigation is to test the hypothesis that the balance N1 and the ERN will be reduced to a similar extent after the intervention, to demonstrate that these brain responses arise from shared brain processes. Transfer of the effect of the psycho-social intervention to the balance N1 would provide insight into prior work demonstrating that balance training can alleviate anxiety in young children, and well-documented benefits of psychotherapy to balance disorders. Collectively, these data may guide the development of multidisciplinary interventions for the prevention and treatment of anxiety disorders in children.

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### Motivational Interviewing to Enhance Behavioral Change in Older Adults With Hoarding Disorder **

**Study Type:** Interventional**Start Date:** June 1, 2022**Eligibility:** 60 Years and Older, Does Not Accept Healthy Volunteers**Location(s):** Mississippi State University, Starkville, Mississippi, United States    

This study will compare two behavioral interventions for hoarding disorder in older adults.

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### Multimodal Assessment of Cannabinoid Target Engagement in Adults With Obsessive-Compulsive Disorder **

**Study Type:** Interventional**Start Date:** March 1, 2022**Eligibility:** 21 Years to 55 Years, Does Not Accept Healthy Volunteers**Location(s):** New York State Psychiatric Institute, New York, New York, United States    

The purpose of this research study is to test how a medication called nabilone (Cesamet) affects neurocognitive processes involved in obsessive-compulsive disorder (OCD), including threat response, processing of fear signals, and habitual behavior. OCD is a disabling illness that affects around 2% of the population and involves recurrent intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that lead to distress and/or impaired functioning. Nabilone is a synthetic form of delta-9-tetrahydrocannabinol (THC, the primary psychoactive component of the cannabis plant). It acts on the brain's endocannabinoid system, which has been hypothesized to play a role in OCD symptoms. Nabilone is approved by the FDA for the treatment of chemotherapy-induced nausea and vomiting. It is not FDA-approved for treating OCD.

In this study, 60 adults with OCD will receive a single dose of either nabilone or placebo. Participants will then complete a series of assessments including neuroimaging, psychophysiology (e.g., skin conductance recording), computerized behavioral tasks, and self-report measures. The information gained from this study could contribute to the development of new treatments for people with OCD and related disorders.

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### Connectomic Deep Brain Stimulation for Obsessive Compulsive Disorder **

**Study Type:** Interventional**Start Date:** August 13, 2021**Eligibility:** 18 Years and Older, Does Not Accept Healthy Volunteers**Location(s):** Mount Sinai West, New York, New York, United States    

Deep brain stimulation (DBS) is an effective treatment for people suffering from severe obsessive-compulsive disorder (OCD) whose symptoms have failed to improve after years and multiple methods of intervention. An effective DBS target for OCD is the anterior limb of the internal capsule (ALIC) brain region. On average 60% of all OCD patients have a clinically significant response to ALIC DBS. However, ALIC DBS may become even more effective with the ability to predict which specific ALIC connections in the brain need to be stimulated for each individual OCD patient. This study therefore investigates personalized stimulation to the ALIC that allows for precise modulation of brain circuits associated with individual OCD symptoms. The study aims to specify the ideal anatomical target for ALIC DBS for maximum therapeutic benefit in each patient.

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### Improving Attentional and Cognitive Control in the Psychological Treatment of Intrusive Thoughts **

**Study Type:** Interventional**Start Date:** April 30, 2021**Eligibility:** 18 Years to 60 Years, Does Not Accept Healthy Volunteers**Location(s):** Massachusetts General Hospital, Boston, Massachusetts, United States    

The investigators are conducting this study to learn more about the cognitive and attentional processes among individuals with three types of repetitive negative thinking (RNT): mental rituals (as seen in obsessive compulsive disorder, OCD), worries (as seen in generalized anxiety disorder, GAD), and ruminations (as seen in major depressive disorder, MDD). Specifically, the investigators are studying whether psychological treatment can help people with RNT who have trouble stopping unwanted thoughts and shifting their attention.

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### Theta Burst Stimulation Plus Habit Override Training for Compulsive Behaviors **

**Study Type:** Interventional**Start Date:** December 28, 2020**Eligibility:** 18 Years to 60 Years, Does Not Accept Healthy Volunteers**Location(s):** Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, United States    

This project seeks to identify causal neural mechanisms underlying unwanted, repetitive behaviors (compulsions). Using non-invasive brain stimulation coupled with practice in a computer task, we will modulate activity in a target brain region and measure effects on compulsive behaviors and related measures. This work could ultimately lead to the ability to treat compulsions more effectively by targeting the regions of the brain that can help or hinder attempts to overcome compulsions.

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### Brain Network Changes Accompanying and Predicting Responses to Pharmacotherapy in OCD **

**Study Type:** Interventional**Start Date:** October 14, 2019**Eligibility:** 18 Years to 65 Years, Accepts Healthy Volunteers**Location(s):** Yale OCD Research Clinic - CMHC/CNRU, 34 Park ST, New Haven, Connecticut, United States    

The proposed randomized, double-blind research study will use functional magnetic resonance neuroimaging using state-of-the-art HCP acquisition protocols and analytic pipelines, to identify predictors and correlates of response to an accepted first-line pharmacological treatment for obsessive-compulsive disorder.

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### Efficacy of Psilocybin in OCD: a Double-Blind, Placebo-Controlled Study. **

**Study Type:** Interventional**Start Date:** November 13, 2018**Eligibility:** 21 Years to 65 Years, Does Not Accept Healthy Volunteers**Location(s):** Connecticut Mental Health Center, New Haven, Connecticut, United States    

This study aims to investigate the effects of oral psilocybin on OCD symptomatology and provide the first evidence of the neural mechanism that may mediate psilocybin's purported therapeutic effects on OCD.

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### Physiological Brain Atlas Development **

**Study Type:** Observational**Start Date:** August 31, 2006**Eligibility:** 6 Years to 90 Years, Does Not Accept Healthy Volunteers**Location(s):** Vanderbilt Univeristy, Nashville, Tennessee, United States    

The NIH grant has funded the development of a physiological brain atlas registry that will allow us to significantly improve the data collectioin and use of physiological data into a normalized brain volume. This initially was used to improve DBS implants for Parkinson's Disease, Dystonia, Essential Tremor, and OCD, but now includes data acquired during all stereotactic brain procedures.