In Focus: Center for OCD & Related Disorders

The Center for OCD and Related Disorders, directed by Dr. Blair Simpson, focuses on how to better understand, and ultimately treat, obsessive-compulsive disorder and related problems like anxiety disorders. Obsessive-Compulsive Disorder (OCD) is characterized by distressing, intrusive, irrational thoughts, images, or impulses (i.e., obsessions) and repetitive behavioral or mental acts (i.e., compulsions) performed to reduce distress or prevent some feared outcome. Dr. Simpson’s lab uses various methods to advance our knowledge of the etiology, phenomenology, and treatment for this debilitating disorder.

Dr. Simpson has led multiple treatment studies to determine how best to deliver evidence-based treatments for OCD, including medications like serotonin reuptake inhibitors (SRIs) and exposure and response prevention (ERP) that are now first-line treatments for the disorder. In a recent study, the findings of which were published in the Proceedings of the National Academy of Sciences of the United States of America (PNAS), Dr. Simpson and her collaborators used functional MRI (fMRI) to scan the brains of people with OCD before and after they completed ERP to learn more about who responds to treatment. Different levels of activity in certain brain areas predicted symptom improvement. These findings give researchers more information about which patients might be more likely to respond to ERP and provide clues about which brain regions might be targeted with new interventions in the future.

The lab also collaborates with experts in neuroimaging, genetics, and basic science to understand how and why the disorder develops. Often chronic, OCD affects approximately 1-3% of the population, results in significant distress and impairment, and is a leading cause of global disability.

One current project that takes global factors into account is an international collaboration that Dr. Simpson is conducting with leading OCD researchers in Brazil, India, the Netherlands, and South Africa. The aim of the study is to identify how the brains of people with OCD might differ from their siblings and unrelated individuals who do not have symptoms of the disorder. Prior research indicates that there are abnormalities in the brain circuitry of people with OCD, but because of limitations of that research, including small sample sizes, there’s a lot that researchers do not understand about the brain and OCD. Therefore, Dr. Simpson and her collaborators are using a multimethod approach to assess study participants with a battery of neurocognitive and clinical assessments to determine if their brain activity is correlated with their performance on these measures. The short-term goal of the study is to identify brain signatures associated with cognitive and clinical profiles common in individuals with OCD and that are reproducible across countries and cultures. The long-term goal is to use this information to transform how clinicians conceptualize, diagnose, and ultimately treat mental illnesses like OCD, paving the way to even better treatments than we have today. 

Because the study involves a global collaboration, the research team will have not only a large sample that is adequately powered to identify effects, but also will be able to examine cultural and environmental factors that might influence the presentation of OCD symptoms. In addition, the collaboration will study healthy siblings of people with OCD. OCD is a highly heritable disorder, but there is a lack of information about why one individual will develop the disorder whereas his or her sibling will not. Including unaffected siblings in the project will enable the team an exciting opportunity to identify abnormalities in the brains of people with OCD that are not present in their healthy siblings, abnormalities that are present in both people with OCD and their unaffected siblings, and brain patterns that are present in unaffected siblings but not their siblings with OCD, thereby revealing information about how the brain may make a person more or less vulnerable to developing the disorder.

If you are interested in learning more about the research being done at the Center for OCD and Related Disorders, please visit: https://www.columbiapsychiatry.org/research-clinics/center-obsessive-compulsive-treatment-and-related-disorders/current-studies. Please join us in our mission to better understand and treat OCD!