Mental Health World Conference 2026

Abstract

Obsessive compulsive disorder (OCD) is a disabling psychiatric condition that can profoundly affect interpersonal relationships, social functioning, and quality of life. Although evidence based treatments can substantially reduce obsessive-compulsive symptoms, symptomatic improvement does not necessarily translate into functional recovery. Social skills represent a particularly relevant but still understudied dimension of functioning in OCD.This study investigated whether social skills are impaired in treatment-naive adults with OCD compared with healthy controls, whether these skills improve following standard OCD treatment, and whether symptom severity, age at onset, and illness duration predict social skills deficits.Forty one treatment naive adults with OCD and 34 healthy controls were assessed using the Social Skills Inventory. Patients were randomly allocated to 12 weeks of standardized treatment with either fluoxetine or group cognitive behavioral therapy and were subsequently reassessed. OCD symptoms were evaluated using the Yale Brown Obsessive Compulsive Scale (YBOCS). Clinical variables were also examined as potential predictors of social skills performance.Patients with OCD demonstrated significantly poorer overall social skills than healthy controls, particularly in assertive conversation and social resourcefulness. Following treatment, OCD symptoms improved significantly; however, social skills remained essentially unchanged. Earlier age of OCD onset predicted poorer overall social skills, whereas symptom severity and illness duration were not significant predictors.These findings reveal an important gap between symptom reduction and functional recovery in OCD. Improvement in core obsessive symptoms may not be sufficient to restore interpersonal functioning, suggesting that social skills may constitute a partly independent and clinically meaningful dimension of illness burden. Furthermore, the association between earlier symptom onset and poorer social skills raises the possibility that OCD emerging during critical developmental periods may interfere with opportunities for social learning and the acquisition of interpersonal competencies.This study therefore challenges a symptom-centered definition of treatment success in OCD. Social functioning should be systematically assessed alongside symptom severity, and social skills may represent an additional therapeutic target for patients whose interpersonal difficulties persist despite clinical improvement. Future research should determine whether interventions specifically addressing social and functional outcomes can help move OCD treatment beyond symptom control toward more comprehensive recovery.