Delay Discounting and Risk Tolerance in Obsessive Compulsive Disorder: Results From the Global OCD Study

Although obsessive compulsive disorder (OCD) features maladaptive decision-making, previous research that examined economic decision-making in OCD has yielded inconsistent results. Here, we examined whether unmedicated adults with OCD ( n = 268) differ from healthy control subjects (HCSs; n = 256) on two measures of decision-making about potential rewards: (a) delay discounting, the tendency to prefer rewards sooner rather than later, even if the delayed reward is larger, and (b) risk tolerance, the willingness to gamble for uncertain rewards when the risk is known. Data were collected in Brazil, India, the Netherlands, South Africa, and the United States as part of the Global OCD study. After controlling for age, sex, education, socioeconomic status, IQ, and site, individuals with OCD did not differ from HCSs in either delay discounting or risk tolerance. However, patients with OCD who reported more anxiety and depression showed higher delay discounting, or a relative preference for immediate rewards.