The authors suggest that screening followed by brief CBT interventions might both reduce symptoms and the risk of progression to OCD. OCD itself often goes unrecognised. Patients may be reluctant to disclose their symptoms because of shame or embarrassment, and fears of stigmatisation. NICE therefore recommends that we should use a six-question screening questionnaire for patients who are at increased risk of OCD. Depression, in particular, commonly occurs in association with OCD and I think a case can be made for asking patients to complete the six-question screen at the same time as the PHQ-9.