title: The cost and impact of compulsivity: A research perspective.
abstract: Compulsivity is the defining feature of various psychiatric disorders including Obsessive Compulsive Related Disorders (OCRDs), and other compulsive, impulsive, and addictive disorders. These disorders are disabling, chronic conditions with an early onset and high rates of comorbidity, misdiagnoses, and delay in treatment onset. Disorders of compulsivity are responsible for considerable socioeconomic burden to society. We review the costs and impacts of compulsivity. In order to facilitate earlier diagnosis and targeted treatments, we examine the overlapping mechanisms that underlie compulsivity. We reconceptualize psychiatric disorders based on core features of compulsivity, highlight challenges in harmonizing research in children and adults, describe newer research methodologies, and point to future directions that can impact the costs and impact of disorders of compulsivity.
authors.affiliation: Autism and Obsessive-Compulsive Spectrum Program, Anxiety and Depression Program, Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA. Electronic address: eholland@montefiore.org.
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.affiliation: Autism and Obsessive-Compulsive Spectrum Program, Anxiety and Depression Program, Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Doernberg
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Roseli
authors.initials: R
authors.lastname: Shavitt
authors.affiliation: Highly Specialized Obsessive Compulsive Disorder and Body Dysmorphic Disorder Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Parkway, Welwyn Garden City, Hertfordshire AL8 6HG, UK; University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Waterman
authors.affiliation: Pediatric OCD Consultation Team, Anxiety Treatment and Research Centre, St. Joseph's Healthcare, McMaster University, 100 West 5th Street, Hamilton, ON, Canada L8N 3K7.
authors.forename: Noam
authors.initials: N
authors.lastname: Soreni
authors.affiliation: VU University Amsterdam Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.affiliation: University of Cambridge School of Clinical Medicine, Department of Psychiatry and MRC / Welcome Trust Behavioral and Clinical Neuroscience Institute Addenbrooke׳s Hospital, Cambridge CB2 2QQ, UK.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sahakian
authors.affiliation: Highly Specialized Obsessive Compulsive Disorder and Body Dysmorphic Disorder Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Parkway, Welwyn Garden City, Hertfordshire AL8 6HG, UK; University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Fineberg
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use; D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D035843:Biomedical Research / Q000191:economics / Q000379:methods* / Q000639:trends; D002648:Child; D003131:Combined Modality Therapy / Q000191:economics; D003192:Compulsive Behavior / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D003193:Compulsive Personality Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D017281:Cost of Illness; D017048:Health Care Costs; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D011600:Psychopharmacology / Q000191:economics / Q000379:methods* / Q000639:trends; D011788:Quality of Life
chemical_list: D014150:Antipsychotic Agents
keywords: Compulsivity; Cost; Diagnosis; OCD; OCRDs; Treatment