Objective: Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive, unwanted thoughts and repetitive behaviors performed to alleviate fear or anxiety. Despite its prevalence, OCD is unrepresented in scientific literature due to misdiagnosis and recent changes in its classification within the DSM-5. The objective of this paper is to review current evidence, and, based on existing studies, identify potential roles of the speech-language pathologist (SLP) in the evaluation and treatment of individuals with voice, upper airway, or swallowing disorders who also present with OCD.

Methods: A narrative review of interdisciplinary literature was conducted across psychiatry, psychology, and speech-language pathology. The review identified common themes regarding the phenomenology of OCD, evidence-based psychological interventions and how these have evolved over time, and their potential interaction with voice, airway, and swallowing therapy processes.
Results:
Preliminary findings suggest that OCD is frequently associated with hypervigilance to bodily sensations, excessive self-monitoring, and repetitive checking behaviors. These characteristics may inadvertently lead to and/or reinforce maladaptive vocal, respiratory, or swallowing patterns and interfere with habituation and maintenance of learned therapy techniques. Consequently, traditional SLP approaches that emphasize awareness, relaxation and internal focus should be considered carefully in this population. Instead, therapeutic strategies emphasizing a more external focus, graded exposure, and modified performance monitoring may be more effective. Interdisciplinary coordination with mental health providers is also recommended to ensure cohesive and ethically appropriate management.

Conclusions: OCD may represent an underrecognized psychosocial factor influencing the onset or persistence of functional voice, cough, and swallowing disorders. It is important for SLP’s to have a general understanding of a complex psychological disorder that may affect their patient’s participation and outcomes in therapy. Incorporating psychologically informed, interdisciplinary approaches within the SLP’s scope of practice can enhance the therapeutic process and promote sustainable long-term outcomes for individuals with co-occurring OCD and communication or swallowing impairments. Further studies are warranted to better characterize this population and guide evidence-based clinical recommendations.