Obsessive-compulsive disorder (OCD) is a chronic illness characterized by repeated unwanted thoughts that lead to difficult-to-control behaviors. For instance, some patients have obsessive thoughts about dirt or germs, associated with the compulsion to wash their hands over and over again. Other patients have obsessive thoughts that they forgot to do something, associated with the compulsion to repeatedly check things like locking the door or turning off the stove.

According to the most recent study, approximately 1 in 40 adults in the United States have met the criteria for a diagnosis of OCD at some point in their lives. 1.2% of the adults met the full criteria in the 12 months prior to the study.

The World Health Organization has ranked OCD as one of the top 20 causes of illness-related disability, worldwide, for individuals between 15 and 44 years of age. Current estimates also suggest that approximately 1 in 100 children has OCD.

What are the symptoms of
obsessive-compulsive disorder?

OCD symptoms include obsessions and compulsions. Obsessions are unwanted thoughts, impulses, and ideas that are unrelenting. These thoughts can get in the way of normal thoughts. Obsessions can include:

  • Fear of losing or misplacing something
  • Fear of germs or contamination
  • Fear of harm to self or loved ones.

Compulsions are behaviors that people repeat to try to control the obsessions. These behaviors could be rigid and structured, or complex behaviors that change. Compulsions can include:

  • Excessively cleaning or washing
  • Keeping or hoarding unnecessary objects
  • Repeatedly checking on things
  • Always moving items to keep them in perfect order.

Some patients with OCD also have tic disorders.  Motor tics are sudden, brief, repetitive movements such as eye blinking, shoulder shrugging, blinking, and facial grimacing. Vocal tics can include sniffling, grunting sounds, or repetitive throat-clearing.


Researchers have not pinpointed the exact cause of OCD, but they’re studying brain abnormalities, genetic (family) influences, and environmental factors. OCD usually begins in adolescence or young adulthood, and tends to appear at a younger age in boys than in girls.

Several parts of the brain, as well as biological processes, play a key role in obsessive thoughts and compulsive behavior, as well as the fear and anxiety related to them. Some children may develop a sudden onset or worsening of OCD symptoms after a streptococcal infection such as strep throat or scarlet fever.

obsessive-compulsive disorder diAGNOSED?

In a diagnostic assessment of a patient with possible OCD, the doctor should specifically ask about the presence of intrusive thoughts, images, or urges, and to inquire about repetitive behaviors and mental rituals.

The DSM-5 diagnostic criteria for obsessive-compulsive disorder (OCD) are as follows:

  • Presence of obsessions, compulsions, or both
  • The obsessions or compulsions are time-consuming (eg, take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication) or another medical condition.
  • The disturbance is not better explained by the symptoms of another mental disorder


According to the National Institute of Mental Health, the two main OCD treatments are psychotherapy and medication.

Cognitive behavioral therapy (CBT), specifically Exposure and Response Prevention (ERP), has been shown to help patients recover from OCD.  ERP teaches you healthy ways to deal with anxiety by gradually exposing patients to their fears or obsessions.

For treatment of OCD in children, mental health professionals help identify strategies to manage stress and increase support to avoid OCD symptoms at school and home.

SSRIs, which are commonly used to treat depression, can also be helpful for the  treatment of OCD.

Work with your doctor to help you find the best medication, dose, and duration of treatment for your OCD. If symptoms of obsessive-compulsive disorder persist after treatment with medications and psychotherapy, other treatments may be available.

SeattleNTC, in conjunction with Swedish Medical Center, is a treatment center for deep brain stimulation (DBS) for patients with very severe cases of OCD.  Please inquire if you would like additional information and to learn whether you or a loved one might qualify.