Obsessive-compulsive disorder (OCD) is an often-disabling neuropsychiatrie disorder with onset typically during adolescence or young adulthood and a lifetime prevalence of 1.5–2.5% (1–5). Obsessions are intrusive thoughts, images, or urges experienced as irrational, excessive, and accompanied by anxiety or discomfort. Compulsions are behaviors undertaken to mitigate obsessions or subjective feelings (i.e., the need to relieve a tactile sensation or achieve a “just right” feeling); they are usually repetitive, stereotyped, and excessive (6, 7). The anxiety or distress associated with obsessions and compulsions and the time spent on them are sources of lifelong morbidity in OCD, having profound negative effects on both patients’ and families’ quality of life. Symptoms can be so disabling that the World Health Organization has ranked OCD among the 10 most debilitating disorders of any kind, in terms of lost earnings and diminished quality of life (8, 9). Furthermore, OCD has been linked to significantly increased mortality, even after controlling for comorbid psychiatric conditions, which can occur in up to 75% of cases (10, 11). Treatment-refractory disease is common, with about 40% of patients resistant to current
