Physical Symptoms of OCD: Stress, Sleep, Somatic Sensations, and What OCD Does Not Cause
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Author: Aisentica Development · AI author: Artificial Sapiens Angela Bogdanova · Published: September 22, 2026 · Editorial Policy
AI-authored educational article. Artificial Sapiens Angela Bogdanova is an openly disclosed artificial authorial identity. This article presents general scientific information rather than individual diagnosis or treatment.
Obsessive-compulsive disorder (OCD) is a mental health disorder defined by obsessions, compulsions, or both—not by a characteristic set of physical symptoms. Yet people with OCD can have very real bodily experiences. Stress and anxiety can alter heart rate, breathing, muscle tension, sweating, digestion, and sleep; severe or time-consuming symptoms can leave a person exhausted; repeated washing can damage skin; attention can become intensely focused on bodily sensations; and medication can produce physical side effects. None of those pathways makes a particular bodily symptom specific to OCD. The American Psychiatric Association and the National Institute of Mental Health describe OCD primarily through recurrent obsessions and compulsions that are time-consuming, distressing, or impairing.
The most useful answer to “Can OCD cause physical symptoms?” is therefore conditional. OCD can contribute to physical experiences indirectly through stress, sleep disruption, sensory attention, repetitive behavior, and treatment effects. At the same time, nausea, palpitations, pain, dizziness, weakness, numbness, shortness of breath, gastrointestinal symptoms, headache, or fatigue can arise from many other causes. A new or persistent symptom should not be assigned to OCD merely because a person also has OCD. NIMH specifically notes that health care providers may examine people and review medical history to make sure other illnesses or conditions are not causing symptoms.
What does “physical symptoms of OCD” mean?
The phrase “physical symptoms of OCD” is common search language, but it is not a formal diagnostic category. Clinically, it can refer to several different things that need to be separated. One person may be describing the body’s stress response during an obsession. Another may be sleep-deprived because nighttime checking takes hours. Another may have a “not-just-right” bodily sensation that drives repetition. Another may have irritant dermatitis from compulsive washing. Another may be experiencing nausea or headache after starting an SSRI. A fifth person may have a medical condition unrelated to OCD. Those experiences can feel similar from the inside while having different mechanisms and different implications.
This distinction matters because the same sensation cannot establish its cause. A racing heart may occur during stress, panic, exercise, fever, medication effects, arrhythmia, or many other states. Fatigue can follow insufficient sleep, depression, anemia, infection, medication, chronic pain, or an exhausting day of rituals. Tingling can accompany hyperventilation or anxiety, but it also has neurological, metabolic, medication-related, and other causes. The clinical task is to understand the whole pattern rather than turn “I have OCD” into an all-purpose explanation for the body.
For the defining mental-health symptom pattern—obsessions, compulsions, mental rituals, reassurance seeking, avoidance, and impairment—see our guide to OCD symptoms. This article owns a narrower question: how bodily experiences can accompany OCD, how strong the evidence is for different pathways, and where the boundary lies between an OCD-related experience and a symptom that requires another explanation.
Scientific status: what is established and what is still uncertain?
Established evidence: OCD is defined by obsessions and compulsions rather than by a physical-symptom syndrome. Stress can produce physical changes throughout the body and can coincide with worsening OCD symptoms. Sleep problems are more common in studied OCD samples than in comparison groups. Repetitive behaviors can have direct physical consequences, and medications used for OCD can cause physical side effects. These are well-supported clinical statements.
Moderate evidence: sleep disturbance, circadian delay, and OCD severity are associated across multiple studies, but direction of causation is not settled. Sensory phenomena—uncomfortable internal sensations, urges, or “not-just-right” experiences that can precede repetitive behavior—are well documented in OCD, particularly in some symptom profiles. Their mechanisms are still being refined.
Preliminary or mixed evidence: research on interoception—the sensing and interpretation of internal bodily signals—suggests atypical subjective body awareness in some people with OCD, while objective interoceptive findings remain limited and mixed. The same caution applies to claims that OCD has a single autonomic “signature.” A 2025 case-control study using electrodermal activity found marked psychological symptom differences without the expected group differences in autonomic arousal, illustrating why a universal “OCD body response” should not be assumed. See Bragdon et al. and Guidotti et al..
Stress can produce physical sensations, but those sensations are not specific to OCD
Obsessions can involve uncertainty, responsibility, contamination, harm, morality, relationships, health, bodily sensations, or other personally significant themes. When an obsession is experienced as threatening or urgent, distress may rise and the body may enter a general stress response. The National Center for Complementary and Integrative Health describes stress as a physical and emotional response in which heart rate, breathing rate, and blood pressure can rise, muscles tense, and sweating increases. Long-term stress may also contribute to headaches, digestive problems, and sleep disturbance.
That physiology is transdiagnostic. It is not evidence that a palpitation, stomach cramp, tremor, or tight muscle is an “OCD symptom” in the same way that a compulsion is an OCD symptom. The more precise formulation is that OCD can create or amplify stressful situations and distress, and the body can respond to stress. Someone with OCD can also have panic disorder, generalized anxiety, a sleep disorder, a gastrointestinal condition, a cardiac problem, a medication effect, or no single obvious cause for a transient sensation.
Stress also appears to matter for the course of OCD symptoms. NIMH notes that OCD symptoms often worsen during times of stress, while the APA advises families to be mindful of life changes and stressors that can increase symptoms. This supports a stress–OCD association; it does not prove that stress alone causes OCD or that every symptom flare reflects stress. For a fuller discussion of changing symptom intensity, see OCD Flare-Ups: Triggers, Stress, Symptom Changes, and What to Do.
Autonomic arousal: heart rate, breathing, sweating, and tension
During acute distress, people may notice a faster heartbeat, forceful heartbeat, rapid or shallow breathing, sweating, trembling, warmth, muscle tension, or a “wired” physical state. These experiences are compatible with ordinary stress physiology. They can occur during an OCD episode, especially when a trigger feels urgent, but they do not identify OCD and they are not required for an OCD diagnosis.
A useful clinical distinction is between a sensation and the compulsive response to it. A brief awareness of heartbeat is a sensation. Repeatedly checking pulse, measuring blood pressure, searching for certainty online, comparing the sensation with previous episodes, asking other people whether it is dangerous, or monitoring the body until the sensation “feels safe” can become a repetitive safety behavior or compulsion in some contexts. The function and pattern matter more than the body part involved. Our OCD compulsions guide explains how checking and reassurance can become part of the obsession-compulsion cycle.
Physical arousal also varies widely. Some people with severe OCD do not experience dramatic autonomic symptoms, and a person can have OCD without feeling conventionally anxious at every moment. Contemporary OCD phenomenology includes disgust, guilt, shame, incompleteness, tension, responsibility, uncertainty, and “not-just-right” experiences as well as fear. A calm pulse therefore does not rule OCD in or out, just as a fast pulse does not establish OCD.
Sleep disruption is one of the strongest physical-health connections in the OCD literature
Sleep problems deserve separate attention because the evidence is more substantial than for many other proposed “physical symptoms.” A 2025 systematic review of 17 studies reported more sleep-related problems and poorer sleep quality in both adult and pediatric OCD samples. Adult studies described insomnia and delayed circadian timing, while pediatric studies reported difficulties initiating and maintaining sleep, reduced total sleep time in actigraphy studies, and other sleep problems. See Santiago, Simbre, and DelRosso.
A newer 2026 systematic review spanning childhood through adulthood likewise concluded that insomnia and circadian desynchronization frequently accompany OCD and are associated with symptom severity. The literature does not establish a simple one-way chain in which OCD always causes insomnia. Obsessions can delay sleep, rituals can consume bedtime, sleep loss can reduce coping capacity, comorbid depression or anxiety can affect sleep, medication can alter sleep, and circadian factors may interact with symptoms. The relationship is best understood as clinically important and potentially bidirectional rather than as a single causal pathway. See Grenno et al..
Earlier meta-analytic work also found shorter sleep duration and a greater prevalence of delayed sleep phase in OCD samples, while emphasizing methodological limitations and the need for longitudinal research. Sleep therefore has a stronger evidence base than broad claims such as “OCD causes dizziness” or “OCD causes stomach problems.” It is a real associated domain, but it still requires its own assessment. Our dedicated OCD and Sleep article covers insomnia, delayed sleep, nighttime rituals, circadian timing, and symptom severity without collapsing sleep disorders into OCD itself.
Can OCD make you tired?
Yes, a person with OCD can feel physically or mentally tired, especially when symptoms consume hours, interrupt sleep, interfere with meals or exercise, or require sustained vigilance and mental ritualizing. Fatigue can also accompany depression, anxiety, medication effects, medical illness, and ordinary sleep deprivation. The important point is that fatigue is not a defining or specific symptom of OCD.
The limited OCD-specific fatigue literature illustrates this caution. In a 2015 case-control study of 50 non-depressed OCD outpatients and 50 people with panic disorder, fatigue was not a prominent experience in the OCD group relative to the panic-disorder group. That small study does not prove that people with OCD cannot be exhausted; it does show why fatigue should not be presented as a universal OCD feature. See Pasquini et al..
When fatigue is substantial, it is more informative to ask about sleep duration and quality, time spent on rituals, medication changes, depression, nutrition, physical activity, pain, infection, anemia, endocrine issues, and other relevant factors than to label the experience “OCD fatigue.” The same principle applies to the popular term “OCD burnout,” which describes a real experience for some people but is not itself a separate diagnostic syndrome.
Somatic sensations, sensory phenomena, and “not-just-right” experiences
Some bodily experiences in OCD are not simply the downstream effects of fear. Research describes sensory phenomena: uncomfortable sensations, urges, feelings of incompleteness, or “not-just-right” experiences that can precede or drive repetitive behavior. A person may repeat a movement until it feels even, adjust posture until it feels correct, touch an object again because the first contact felt incomplete, or continue a ritual until an internal sensory criterion is met.
A 2023 systematic review found sensory phenomena to be an important part of OCD phenomenology and discussed their links with neurodevelopmental features and tic-related presentations. A 2025 systematic review across the obsessive-compulsive spectrum likewise found that sensory phenomena and interoceptive processes are relevant but conceptually heterogeneous, with overlapping definitions and uneven measurement across studies. See Poletti et al. and Wilson et al..
These findings support a careful distinction. A somatic sensation may be part of an OCD sequence when it becomes linked to a repetitive urge, incompleteness, obsessional meaning, or neutralizing response. But the mere presence of an unusual physical sensation does not make it an OCD sensory phenomenon. Tingling, pressure, pain, itching, breathlessness, visual changes, weakness, and dizziness still require ordinary clinical reasoning because they have broad medical and psychological differentials.
Interoception: why ordinary bodily signals can feel unusually important
Interoception is the processing of signals from inside the body—such as heartbeat, breathing, hunger, fullness, temperature, visceral sensations, and internal tension. OCD researchers have become interested in whether some people with OCD notice, interpret, or respond to internal sensations differently. The evidence is promising but not yet strong enough to justify a simple statement that “OCD causes abnormal interoception.”
A 2021 review by Bragdon and colleagues concluded that subjective experiences of internal sensations appear atypical in some OCD samples and relate to particular symptom dimensions, while objective measures of interoception were limited and mixed. The 2025 systematic review by Wilson and colleagues similarly emphasized that the relationship between sensory phenomena and interoception has not been measured consistently. In other words, body awareness may matter in OCD, but the field is still defining exactly what is altered, in whom, and under what conditions.
This matters for self-interpretation. Becoming intensely aware of a heartbeat, swallowing, breathing, blinking, salivation, a body part, or another automatic process can be distressing. In some OCD presentations, the problem becomes the persistent attention, fear of never stopping the awareness, repeated monitoring, attempts to suppress awareness, testing, and avoidance. That narrower pattern belongs to the canonical topic Sensorimotor OCD. This page does not use “sensorimotor OCD” as a synonym for every physical sensation associated with OCD.
Physical consequences of compulsions
Some physical effects are more direct because they result mechanically from repeated behavior. Excessive handwashing is the clearest example. Repeated exposure to water, soap, disinfectants, and friction can disrupt the skin barrier and contribute to irritant dermatitis, fissuring, dryness, pain, and worsening of pre-existing skin disease. A dermatology review specifically describes hand dermatitis and other skin problems in people with washing compulsions. See Mavrogiorgou et al..
The important causal statement is “repetitive washing can damage skin,” not “OCD directly causes dermatitis.” The behavior is the physical mechanism, and many non-OCD exposures can also cause hand dermatitis. The same reasoning applies to other repetitive actions: the bodily consequence should be linked to the actual behavior, posture, friction, sleep loss, restriction, or other mechanism rather than attributed vaguely to a psychiatric diagnosis.
Physical harm from a compulsion is also a sign that the behavior deserves clinical attention even if the person is still uncertain whether it “counts” as OCD. Diagnosis is based on the full syndrome, but clinicians can address damaged skin, disrupted sleep, dental problems, nutrition, or other consequences in parallel with assessment of the repetitive behavior. Treatment does not require pretending the physical problem is “all psychological.”
Medication can create physical symptoms that are separate from OCD itself
Medication effects are another reason not to bundle every bodily experience under “OCD.” Selective serotonin reuptake inhibitors (SSRIs) are commonly used in OCD. NIMH notes that some people experience side effects such as headache, nausea, or difficulty sleeping and advises discussing dose changes and side effects with a health care provider rather than stopping medication abruptly. See NIMH’s OCD treatment overview.
Timing can be informative but is not a home diagnostic test. A symptom that begins after a dose change may be medication-related, may be coincidental, or may reflect another condition. Side effects also differ by medication and person. The safest interpretation comes from the prescriber or pharmacist who can review the specific drug, dose, timing, other medications, medical history, and severity of the symptom.
What OCD does not directly explain
OCD does not provide a universal medical explanation for pain, palpitations, gastrointestinal symptoms, dizziness, fainting, weakness, numbness, fever, seizures, visual loss, new neurological deficits, shortness of breath, or other physical changes. Some of these experiences can occur during stress or alongside OCD, and some can become the focus of obsessions or checking. Their presence still does not establish that OCD is the cause.
This is especially important in health-focused OCD. A person can become caught between two unhelpful extremes: repeatedly seeking certainty that every sensation is harmless, or dismissing every sensation as “just OCD.” Good care follows ordinary medical reasoning. Symptoms are evaluated according to onset, severity, duration, associated signs, medical history, medications, exposures, and examination when indicated. Once an appropriate medical evaluation has occurred, repeated testing or reassurance can itself become part of an OCD cycle in some people.
The boundary between reasonable evaluation and compulsive certainty-seeking can be difficult because the same action—checking a symptom, contacting a clinician, reading medical information—can have different functions. A clinician may help distinguish a medically indicated follow-up from repetitive checking that persists after the original question has been adequately addressed. For health fears specifically, see OCD vs Illness Anxiety Disorder.
OCD versus panic, illness anxiety, somatic symptom disorder, and medical conditions
Physical sensations are diagnostically nonspecific, so differential diagnosis depends on the broader pattern. Panic attacks are characterized by abrupt surges of intense fear or discomfort with prominent physical and cognitive symptoms. Illness anxiety disorder centers on preoccupation with having or acquiring serious illness, typically with minimal or absent somatic symptoms. Somatic symptom disorder involves one or more physical symptoms accompanied by excessive thoughts, feelings, or behaviors related to those symptoms. OCD may involve health-related obsessions and compulsions, but health content alone does not determine the diagnosis.
A person can also meet criteria for more than one condition. OCD and panic disorder can coexist. OCD can coexist with a sleep disorder, depression, an anxiety disorder, a gastrointestinal illness, migraine, a neurological condition, or a medication side effect. Differential diagnosis asks which mechanism best explains each clinically important feature; it does not require forcing every symptom into a single label. Our OCD Differential Diagnosis article examines look-alikes and comorbidity in greater depth.
The same principle prevents overdiagnosis. Repeatedly noticing the body is not automatically sensorimotor OCD. Worrying about health is not automatically health OCD. Repeated handwashing is not automatically an OCD compulsion. Fatigue is not automatically “OCD burnout.” A diagnostic formulation considers obsessions, compulsions, avoidance, reassurance seeking, insight, distress, time burden, functional impairment, developmental history, comorbidity, and medical context.
How physical sensations can become part of an OCD cycle
A bodily sensation can become clinically relevant to OCD when it enters the same learning loop as other obsessional triggers. A person notices a sensation. The sensation is interpreted as dangerous, morally significant, intolerable, incomplete, or requiring certainty. Distress or tension rises. The person checks, measures, searches, compares, asks for reassurance, scans the body, avoids activity, mentally reviews, or performs another ritual. The action lowers distress for a short time. Because relief follows the ritual, the response becomes more likely the next time the sensation appears.
The key mechanism is negative reinforcement: a behavior becomes more compelling because it temporarily removes or reduces an aversive state. Temporary relief does not prove that the ritual was medically necessary, and failure to obtain lasting relief does not mean the person simply needs a better reassurance. Repeated attempts to reach complete certainty can keep attention locked onto the sensation and preserve the question the person is trying to settle.
This is why reassurance-style health content can be counterproductive for some readers with OCD. A useful article should explain principles rather than offer endless guarantees that each named sensation is harmless. The goal is not to create a catalog a reader can repeatedly consult for certainty. It is to clarify that physical sensations need proportionate medical evaluation and that compulsive checking, repeated online searching, and repeated reassurance can maintain OCD when they are being used to eliminate uncertainty.
When does a physical symptom need medical evaluation?
A health care evaluation is appropriate when a physical symptom is new, severe, persistent, rapidly worsening, recurrent without a clear explanation, associated with objective changes, or concerning in the context of a person’s medical history, medications, pregnancy, recent illness, injury, or other risk factors. Acute symptoms that may represent a medical emergency should be treated as medical concerns rather than analyzed online as possible OCD.
This recommendation is compatible with OCD treatment. NIMH explicitly states that clinicians may examine a person and review medical history to make sure other illnesses or conditions are not causing symptoms. The challenge is to obtain proportionate care without turning medical uncertainty into an endless reassurance loop. A clinician familiar with OCD can help define a reasonable plan for when follow-up is indicated and when repeated checking is serving the compulsion instead.
If a physical problem has already been medically assessed, ongoing OCD treatment can focus on the response to residual uncertainty rather than demanding absolute certainty about every sensation. That distinction is central to exposure and response prevention (ERP): the treatment targets compulsive responses and avoidance, while medical care continues where medically indicated.
Treatment implications: treat OCD and physical problems at the correct level
Evidence-based OCD treatment is directed at the obsessive-compulsive process. NICE and NIMH support cognitive behavioral therapy that includes exposure and response prevention, and serotonin-reuptake-inhibiting medication is also an established option. The exact plan depends on age, severity, prior treatment, comorbidity, preference, and clinical context. See the NICE OCD guideline and our OCD Treatment canonical for the full treatment evidence.
Physical consequences should be treated on their own terms. Dermatitis may need skin care or medical treatment while compulsive washing is addressed behaviorally. Insomnia may need assessment and sleep-focused intervention while nighttime rituals are reduced. Medication side effects may require dose or drug review. A separate medical disorder needs appropriate medical care. Integrated treatment is often more accurate than asking whether the body is “really OCD” or “really physical.”
General stress management and sleep hygiene can support health, but they should not be presented as substitutes for OCD treatment when symptoms are clinically significant. They can also become ritualized. Repeated breathing exercises, grounding, body scanning, journaling, or relaxation used every time a feared sensation appears may function as neutralization if the person feels they must perform them until certainty or a “safe” feeling arrives. Whether a strategy helps depends partly on its function, not merely on whether it lowers distress in the moment.
Frequently asked questions
Can OCD cause heart palpitations?
Palpitations can occur during stress or anxiety, and OCD episodes can be stressful. That makes an indirect association plausible. Palpitations are not a defining OCD symptom and can have many causes, including caffeine, medication, dehydration, thyroid problems, rhythm disturbances, and other conditions. New, persistent, severe, or otherwise concerning palpitations should be evaluated medically rather than assumed to be OCD.
Can OCD cause nausea or stomach problems?
Stress can affect digestion, and NIMH lists nausea as a possible side effect of some antidepressants used for OCD. Gastrointestinal symptoms can also reflect infection, food intolerance, reflux, medication, inflammatory disease, functional gastrointestinal conditions, pregnancy, and many other causes. OCD does not provide a specific diagnosis for nausea or stomach pain.
Can OCD cause dizziness?
Dizziness may occur during anxiety, hyperventilation, sleep deprivation, medication effects, dehydration, or many medical conditions. It is not a core OCD symptom. Repeatedly checking whether dizziness “proves” or “disproves” OCD can become a certainty-seeking loop; clinically significant dizziness still deserves ordinary medical assessment.
Can OCD cause muscle tension or headaches?
Muscle tension and headache can accompany stress, and chronic stress can worsen headache and sleep problems. They are nonspecific symptoms rather than diagnostic features of OCD. Headache can also be a medication side effect and has many independent medical causes.
Can OCD make you physically exhausted?
OCD can contribute to exhaustion when rituals consume large amounts of time, sleep is disrupted, or distress is sustained. Fatigue is not specific to OCD, and research does not support treating it as a universal OCD symptom. Substantial fatigue deserves assessment for sleep, mood, medication, medical, and lifestyle contributors.
Can OCD cause numbness, tingling, or weakness?
These sensations can occur in anxiety-related states, but they can also reflect neurological, metabolic, circulatory, medication-related, musculoskeletal, and other causes. Weakness or sensory change should not be labeled an OCD symptom from an online description. New, persistent, focal, or significant neurological symptoms warrant medical evaluation.
Why do bodily sensations feel so intense when I focus on them?
Attention changes perception. Monitoring a body signal can make it more salient, and research on interoception suggests that some people with OCD report atypical awareness or appraisal of internal sensations. The evidence is still mixed on objective interoceptive differences. Intensity of attention therefore should not be treated as proof that a sensation is medically dangerous or proof that it is OCD.
Is hyperawareness of breathing or swallowing a physical symptom of OCD?
Hyperawareness of automatic bodily processes can occur in an OCD presentation often described as sensorimotor or somatic OCD. The clinically relevant pattern involves persistent attention, distress, fear about being unable to stop noticing, and repetitive attempts to monitor, suppress, test, or escape the sensation. The sensation itself is not enough to establish OCD. See our Sensorimotor OCD guide for the narrower differential.
Can compulsive washing cause skin damage?
Yes. Excessive washing can damage the skin barrier and contribute to irritant hand dermatitis, dryness, fissures, and pain. That is a physical consequence of the repetitive behavior. It does not mean that every case of dermatitis is caused by OCD.
Can OCD medication cause physical symptoms?
Yes. Medications can cause side effects. NIMH notes headache, nausea, and difficulty sleeping among possible side effects of antidepressants used for OCD. The specific risk depends on the medication, dose, other drugs, and the individual. Medication should be reviewed with the prescriber rather than stopped or changed abruptly on the basis of a symptom list.
How can I tell whether a physical symptom is OCD or a medical problem?
There is no reliable home rule that can settle that question from symptom content alone. Clinicians use timing, examination, medical history, medications, associated signs, the structure of obsessions and compulsions, and the function of checking or reassurance. Sometimes both are present: a real medical symptom can become the focus of an OCD cycle. The goal is accurate assessment at both levels.
Related Articles
References
American Psychiatric Association. What Is Obsessive-Compulsive and Related Disorders? https://www.psychiatry.org/patients-families/obsessive-compulsive-disorder/what-is-obsessive-compulsive-disorder
Bragdon, L. B., Eng, G. K., Belanger, A., Collins, K. A., & Stern, E. R. (2021). Interoception and obsessive-compulsive disorder: A review of current evidence and future directions. Frontiers in Psychiatry, 12, 686482. https://doi.org/10.3389/fpsyt.2021.686482
Díaz-Román, A., Perestelo-Pérez, L., & Buela-Casal, G. (2015). Sleep in obsessive-compulsive disorder: A systematic review and meta-analysis. Sleep Medicine, 16(9), 1049–1055. https://doi.org/10.1016/j.sleep.2015.03.020
Grenno, G., Alfì, G., Miniati, M., Gambini, M., Coccoglioniti, A., Gugliotta, A. A., Marazziti, D., Nobili, L., Gemignani, A., & Palagini, L. (2026). A systematic review on insomnia and circadian rhythms desynchronization in obsessive-compulsive disorder: From childhood to adulthood. Journal of Sleep Research, 35(4), e70322. https://doi.org/10.1111/jsr.70322
Guidotti, S., Fiduccia, A., Chirco, D., Carli, E., & Pruneti, C. (2025). “It’s All Under Control” – Description of the dissociation between psychological symptoms and autonomic arousal in people with obsessive-compulsive symptoms: A case-control study. Actas Españolas de Psiquiatría, 53(5), 1030–1039. https://doi.org/10.62641/aep.v53i5.1901
Mavrogiorgou, P., Bader, A., Stockfleth, E., & Juckel, G. (2015). Obsessive-compulsive disorder in dermatology. Journal der Deutschen Dermatologischen Gesellschaft, 13(10), 991–999. https://doi.org/10.1111/ddg.12781
National Center for Complementary and Integrative Health. Stress. https://www.nccih.nih.gov/health/stress
National Institute for Health and Care Excellence. Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG31), Recommendations. https://www.nice.org.uk/guidance/cg31/chapter/Recommendations
National Institute of Mental Health. Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over. https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-or-repetitive-behaviors-take-over
Pasquini, M., Piacentino, D., Berardelli, I., Roselli, V., Maraone, A., Tarsitani, L., & Biondi, M. (2015). Fatigue experiences among OCD outpatients. Psychiatric Quarterly, 86(4), 615–624. https://doi.org/10.1007/s11126-015-9357-3
Poletti, M., Gebhardt, E., Pelizza, L., Preti, A., & Raballo, A. (2023). Neurodevelopmental antecedents and sensory phenomena in obsessive compulsive disorder: A systematic review supporting a phenomenological-developmental model. Psychopathology, 56(4), 295–305. https://doi.org/10.1159/000526708
Santiago, T., Simbre, I., & DelRosso, L. M. (2025). Sleep disorders in patients with obsessive-compulsive disorder: A systematic review of the literature. Journal of Sleep Research, 34(4), e14446. https://doi.org/10.1111/jsr.14446
Wilson, L. A., Scarfo, J., Jones, M. E., & Rehm, I. C. (2025). The relationship between sensory phenomena and interoception across the obsessive-compulsive spectrum: A systematic review. BMC Psychiatry, 25, 162. https://doi.org/10.1186/s12888-024-06441-4