Evidence map›Paper›PMID 42038732›Full record

ReviewCureus2026

Impulsivity and Compulsivity in Obsessive-Compulsive Spectrum Disorders: Clinical Implications for Treatment Sequencing.

Bradley S Bohall, Alexander Gorbis, Eda Gorbis

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Bradley S BohallBiology, University of California, Los Angeles, Los Angeles, USA.
Alexander GorbisPsychology, Westwood Institute for Anxiety Disorders, Los Angeles, USA.
Eda GorbisPsychology, Westwood Institute for Anxiety Disorders, Los Angeles, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Obsessive-compulsive disorder (OCD) and related disorders comprise a heterogeneous group of neuropsychiatric conditions characterized by intrusive thoughts and repetitive behaviors. While traditionally conceptualized as disorders of compulsivity, emerging evidence supports a dimensional model in which impulsivity represents a critical and interacting construct that influences clinical presentation, comorbidity patterns, and treatment response. This interaction is increasingly understood through dysfunction within cortico-striato-thalamo-cortical circuitry and associated large-scale brain networks that regulate reward processing, habit formation, and executive control. Comorbidity with impulsivity-related conditions, including attention-deficit/hyperactivity disorder (ADHD), body dysmorphic disorder, autism spectrum disorder, and addictive behaviors, introduces additional complexity and may significantly interfere with engagement in standard treatments such as ERP. Recent advances in neuroimaging and neurocognitive research have identified impairments in frontoparietal control networks and hub regions involved in cognitive flexibility and inhibitory control, providing a mechanistic framework for the coexistence of impulsive and compulsive features. Pharmacological management further reflects this complexity. While selective serotonin reuptake inhibitors remain first-line treatments for compulsivity, patients with prominent impulsivity or comorbid ADHD often demonstrate an incomplete response. Emerging evidence suggests that targeted pharmacologic strategies, including stimulant and nonstimulant agents, may enhance top-down cognitive control and improve engagement with behavioral therapies when applied judiciously. This narrative review synthesizes current neurobiological, clinical, and pharmacological evidence to examine the multidimensional relationship between impulsivity and compulsivity across OCD spectrum disorders. It proposes a sequential treatment framework in which stabilization of impulsivity and disruptive comorbidities precedes intensive OCD-focused intervention. Integrating dimensional psychiatry with neurobiological insights may improve treatment planning, enhance therapeutic engagement, and optimize outcomes in complex OCD presentations.

Indexed as

comorbiditycompulsivitydimensional psychiatryexposure and response preventionimpulsivityobsessive-compulsive disorder

Identifiers

PMID42038732
PMCPMC13108950

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.