Obsessive-compulsive disorder: Symptoms, causes, and treatment

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by distressing, intrusive, obsessive thoughts and repetitive, compulsive physical or mental acts.

It is a distinct condition but falls within the category of “obsessive-compulsive and related disorders.”

Fast facts on obsessive-compulsive disorder

Common compulsions include washing, cleaning, checking, and repeating.

The American Psychiatric Association (APA) state that females are affected at a slightly higher rate than men, and that OCD affects people of all races and socioeconomic backgrounds.

Some people with OCD successfully hide their symptoms in fear of embarrassment or stigma.

Treatment options include therapy and medication.

What is OCD?

Peas in a row
Perfectionism and concern about evenness or exactness are obsessions apparent in OCD.

OCD is a mental health condition that centers around a debilitating obsession or compulsion, distressing actions, and repetitive thoughts.

A 2001 World Health Organization (WHO) mental health report estimated that OCD was among the top 20 causes of illness-related disability worldwide for people aged 15 to 44 years.

The report also suggested that OCD was the fourth most common mental illness after phobias, substance abuse, and major depression.

OCD is associated with a wide range of functional impairments and has a significant impact on social and working life.


There are several types of OCD that present in different ways.

Checking: This is a need to repeatedly check something for harm, leaks, damage, or fire. Checking can include repeatedly monitoring taps, alarms, car doors, house lights, or other appliances.

It can also apply to “checking people.” Some people with OCD diagnose illnesses they feel that they and the people close to them might have. This checking can occur hundreds of times and often for hours, regardless of any commitments the individual may have.

Checking can also involve repeatedly confirming the authenticity of memories. A person with OCD might repeatedly validate letters and e-mails for fear of having made mistakes. There may be a fear of having unintentionally offended the recipient.

Contamination or mental contamination: This occurs when a person with OCD feels a constant and overbearing need to wash and obsesses that objects they touch are contaminated. The fear is that the individual or the object may become contaminated or ill unless repeated cleaning takes place.

It can lead excessive toothbrushing, overcleaning certain rooms in the house, such as the bathroom or kitchen, and avoiding large crowds for fear of contracting germs.

Mental contamination is the feeling of being ‘dirty’ after being mistreated or put down. In this type of contamination, it is always another person that is responsible. A person with OCD will try to ‘scrub away’ this feeling by showering and washing excessively.

Hoarding: This is the inability to throw away used or useless possessions.

Rumination: Ruminating involves an extended and unfocused obsessive train of thought that focuses on wide-ranging, broad, and often philosophical topics, such as what happens after death or the beginning of the universe.

The person may seem detached and deep in thought. However, the ruminating never reaches a satisfactory conclusion.

Intrusive thoughts: These are often violent, horrific, obsessional thoughts that often involve hurting a loved one violently or sexually.

They are not produced out of choice and can cause the person with OCD severe distress. Because of this distress, they are unlikely to follow through on these thoughts.

These thoughts can include obsessions about relationships, killing others or suicide, a fear of being a pedophile, or being obsessed with superstitions.

Symmetry and orderliness: A person with OCD may also obsess about objects being lined up to avoid discomfort or harm. They may adjust the books on their shelf repeatedly so that they are all straight and perfectly lined up, for example.

While these are not the only types of OCD, obsessions and compulsions will generally fall into these categories.

Person washing hands
Constant hand-washing and washing and cleaning in a specific way are common OCD compulsions.

Despite a wealth of research, the exact causes of OCD have not been identified.

OCD is thought to have a neurobiological basis, with neuroimaging studies showing that the brain functions differently in people with the disorder. An abnormality, or an imbalance in neurotransmitters, is thought to be involved in OCD.

The disorder is equally common among adult men and women.

OCD in children

OCD that begins in childhood is more common in boys than girls, with the usual time of onset of OCD later for females than males.

The condition might be triggered by a combination of genetic, neurological, behavioral, cognitive, and environmental factors.

Genetic causes

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