A risk factor that can predispose some individuals to develop OCD is a group of inherited adrenal gland enzyme disorders that affect the body’s steroid hormone production. Despite the effects of these enzymes on cortisol, several androgen hormones,  and other neurosteroids that modulate anxiety in the body, these disorders were often never diagnosed at the time of this study.

This study by Drs. Altemus and Jacobs sought to test treatment-resistant OCD patients for enzyme abnormalities; if abnormalities were present, they would be eligible to take part in a trial of ketoconazole (an antifungal drug), given its promise in normalizing hormonal profiles.