Reassurance-seeking across anxiety and obsessive-compulsive and related disorders: A systematic review.

There is increasing evidence that reassurance-seeking is a key maintaining factor for anxiety and obsessivecompulsive and related disorders (OCRDs).This systematic review (PROSPERO: CRD42024514395) aimed to identify the nature, underlying motivations, and impact of reassurance-seeking across these disorders.Databases (MEDLINE, APA PsycINFO, and Embase) were first searched in February 2024, and again in July 2025 to identify quantitative studies.Narrative synthesis was used to combine findings, and quality of studies were appraised using Mixed Methods Appraisal Tool.Nineteen studies were included representing 5,865 participants.In adults with obsessive-compulsive disorder, higher levels of carefulness, intensity and trust in reassurance-seeking were reported compared with both healthy and anxious controls.Although reassurance-seeking was motivated by general threat for all disorders, motivations of social attachment and decision-making were not found in panic disorder and generalized anxiety disorder, respectively.The impact of reassurance was similar across disorders, with reassurance provision providing immediate relief (e.g., in anxiety) but leading to more negative feelings in the longer term.Limitations of the literature included its narrow focus predominantly on adult obsessive-compulsive disorder populations in Western countries, with fewer studies focusing on child populations and other OCRDs or anxiety disorders.Overall, findings suggest that reassurance-seeking is transdiagnostic process across anxiety and disorders and OCRDs, but its manifestation and motivation may vary across disorders.Further research is needed to delineate these potential differences, and their implications for treatment. Public Health Significance StatementThe current review suggests that reassurance-seeking manifests differently and has different motivations, across anxiety and obsessive-compulsive and related disorders.However, the long-term negative impacts of reassurance-seeking, such as increased anxiety, are consistent across these disorders.Further understanding of these disorder-specific features may help clinicians tailor assessment and treatment of reassurance-seeking to optimize treatment outcomes.