When Posttraumatic Stress Disorder and Obsessive-Compulsive Disorder Co-occur: A Brief Review of Diagnostic and Treatment Considerations

Posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are highly distressing and impairing conditions that frequently co-occur and share overlapping symptoms. Trauma exposure, particularly interpersonal or sexual trauma, is common among individuals with OCD and may exacerbate or precipitate onset. These disorders feature intrusive thoughts, maladaptive avoidance strategies, and heightened distress, which may contribute to diagnostic complexity and challenges in treatment. This article outlines shared vulnerabilities, including heightened responsibility and intolerance of uncertainty, and summarizes current best practices for treatment for each condition, including prolonged exposure, cognitive processing therapy, and exposure and response prevention, as well as considerations for when and how to modify in cases of comorbidity, and reviews these alongside pharmacological treatments. Clinical considerations for differential diagnosis, functional assessment, treatment planning, and future research directions are discussed.