Canadian Network for Mood and Anxiety Treatments (CANMAT) and International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) 2025 international guidelines for the management of patients with obsessive-compulsive disorder

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BACKGROUND: As a joint effort by the Canadian Network for Mood and Anxiety Treatments (CANMAT) and the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS), these treatment guidelines provide an up-to-date synthesis of published literature on the efficacy, safety, and tolerability of the range of interventions available for the management of obsessive-compulsive disorder (OCD) across the lifespan. The primary goal is to provide clear, easy to use recommendations for practicing clinicians. METHODS: A global group of OCD experts were divided into panels to develop specific sections based on internal group discussions and the evidence extracted from systematic literature searches. CANMAT-defined Levels of Evidence, as well as level of clinical support were used to inform Lines of Treatment and final treatment recommendations. Drafts were revised based on feedback from individuals with lived experience, expert peer review, and a defined expert consensus process. RESULTS: These OCD Guidelines include seven sections spanning foundations of management and diagnosis, psychological, pharmacological, and neuro-modulation treatment modalities, treatment resistance, children and adolescents, special populations and future directions. Recommendations are summarized in tables for ease of reference and caveats and limitations of the current evidence are discussed. CONCLUSIONS: The CANMAT/ICOCS 2025 OCD International Guidelines synthesize the evidence on the efficacy, safety, and tolerability of the range of interventions available for the management of OCD. It is anticipated that these new OCD guidelines will enable psychiatrists and other clinicians to provide systematic, evidence-based care for their patients with OCD across the lifespan.

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