Authors: Melina Albanese, PhD Candidate, University of Toronto | Editors: Romina Garcia de leon, Janielle Richards (Blog Coordinators) | Reviewer: Emilie Theberge
Published: October 3rd, 2025
What is OCD?
Obsessive-compulsive disorder (OCD), is a chronic neuropsychiatric disorder characterized by obsessions, compulsions, or both. Obsessions are intrusive and unwanted recurring thoughts, urges, or images that lead to anxiety or distress. Compulsions are repetitive behaviours or mental acts that an individual performs in response to obsessions or rigid rules and are aimed at reducing distress or preventing a dreaded event or situation. Although performed with the intention of reducing distress, engaging with compulsions can interfere with daily activities and contribute to distress in individuals with OCD. OCD also increases the risk of developing depression and can interfere with work, social, and family life.
Despite these impacts, there are effective evidence-based treatments available to help individuals living with OCD manage their symptoms. While medication can help some individuals with OCD to manage symptoms, it is essential that everyone have access to effective psychological interventions so they can make informed treatment decisions based on evidence and personal preference.
OCD in Women
Women appear to be at higher risk of experiencing OCD than men, across the life course. In affected individuals, OCD symptoms typically start before age 30. (Most mental health disorders begin during adolescence or young adulthood, although later onset is not uncommon.) Research examining differences in co-occurring conditions (comorbidity) and symptoms between women and men has been somewhat conflicting across studies and is ongoing.
The higher prevalence of OCD in women appears to be related to vulnerability during reproductive life events, such as menarche (first menstrual period) and pregnancy. Recent research novel in its approach to screen for perinatal specific symptoms of OCD has shown that OCD may occur in up to 7.8% of pregnancies and in 16.8% of women at some point during the postpartum period, with many cases appearing to resolve with time. OCD that develops during the perinatal or postpartum period, obsessions and compulsions tend to focus on the unborn child or the newborn infant and can lead to difficulties in parenting and child development. Several reasons may explain susceptibility to OCD during pregnancy and postpartum periods, including physiological changes (e.g., fluctuating hormone levels), the heightened sense of responsibility that comes with caring for a newborn, and increased perception of threat.
Pharmacotherapy or psychotherapy?
There are effective evidence-based treatments available to help individuals living with OCD manage their symptoms.
One type of first-line (initial) treatment is pharmacotherapy (treatment with medication). Most often, medications used to treat OCD are selective serotonin reuptake inhibitors (SSRIs), which are also commonly used to treat other mental health conditions that may co-occur alongside OCD, such as depression and generalized anxiety disorder. Dosages used to treat OCD tend to be higher than for other mental health conditions, and side effects such as gastrointestinal symptoms and headaches may occur.
Another recognized first-line treatment for OCD is a type of psychotherapy known as cognitive-behavioural therapy (CBT); specifically, a type of CBT known as exposure with response prevention (ERP) has shown to be effective at improving OCD symptoms.
A lot of research has investigated the risks and benefits of different treatments for OCD. While both medication and therapy show effectiveness at treating OCD, combining psychological and pharmacotherapy is superior to medication alone (but not CBT alone) in treating OCD symptoms. Medication may enhance the effectiveness of CBT-based therapies in treating both OCD symptoms and co-occurring depressive symptoms.
Patient preference and motivation are important factors when deciding on a treatment plan. For these reasons, it is critical that both types of mental health care are accessible to everyone.
Improving access to psychotherapy is important
Evidence-based mental health care is inaccessible to many Canadians for several reasons including stigma, long wait times, and lack of mental health service integration – among others. Further, despite some evidence that most patients prefer psychological treatment (i.e., psychotherapy) versus medication to treat their psychiatric symptoms (particularly younger individuals and women), psychotherapy in particular is inaccessible to many. Cost is a commonly reported barrier to accessing evidence-based mental health care in Canada, and particularly psychotherapy.
This may be especially true for certain populations. For example, research demonstrates that pregnant individuals also generally prefer psychotherapy over pharmacotherapy to manage anxiety-related (including OCD) symptoms. Improving access to varying evidence-based treatments for pregnancy planning and pregnant individuals is therefore important to support symptom management during their reproductive years.Perinatal healthcare providers may be of assistance in advocating for this and connecting women with appropriate, evidence-based mental health care supports that align with personal preferences.
In consultation with a health care practitioner, people with OCD should be allowed to choose the treatment plan that aligns with their needs and preferences. Improving access to psychotherapy is important given patient preferences and evidence in favour of psychotherapy in isolation or in combination with medication over medication alone.