In this review, we expand on previous models of the neurocircuitry involved in OCD [12–13, 16] to propose a heuristic neurocircuit-based taxonomy which could be used to guide the treatment of the disorder in future. We do so by firstly providing case vignettes in which patients describe their symptoms, covering much of the phenotypic expression of OCD. Second, we present hypothetical associations between the phenomenology of OCD symptoms and underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider treatments that could target those specific neurocircuit dysfunctions to improve therapeutic response. Fourth, we suggest ways in which this neurocircuit-based taxonomy could be tested in future research to support or refute our hypothesized links between aspects of clinical phenomenology, specific neurocircuit alterations and treatment methods. Finally, we discuss limitations to the neurocircuit-based approach, in particular the challenge involved in attempting to map different clinical profiles that overlap in individual patients, onto discrete neurocircuits, which are interconnected and affect each other.
