Obsessive-Compulsive Disorder Is Associated With Broad Impairments in Executive Function: A Meta-Analysis

Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). Although there is growing evidence for EF impairments associated with OCD, results have been inconsistent, which makes the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 studies in which participants with OCD were compared with healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.