What are the symptoms of OCD?
Obsessions are thoughts that intrude on the mind—fears of contamination or of causing harm, a need for symmetry or exactness, or unwanted violent, sexual or religious thoughts. Compulsions are behaviors or rituals repeated to reduce anxiety, such as handwashing, checking, counting, arranging or praying silently. They bring brief relief but feed a vicious cycle that makes the obsessions stronger.
Diagnosis and prevalence
DSM-5 diagnoses OCD when obsessions or compulsions take up more than an hour a day or cause significant distress or impairment. In the 2010 US National Comorbidity Survey Replication, more than a quarter of respondents had experienced obsessions or compulsions, but lifetime prevalence of diagnosable OCD was 2.3% and 12-month prevalence was 1.2%. Anxiety disorders, depression and tic disorders often occur alongside it.
Causes
Dysfunction in the cortico-striato-thalamic circuit, the serotonin system and genetics are thought to be involved. Cases where children suddenly develop OCD symptoms after a strep infection are also being studied. For theories about learned links between thoughts and behaviors, see cognitive behavioral theory.
Treatment
- Exposure and response prevention (ERP): gradually facing anxiety-provoking situations while practicing not doing the compulsion. In a 2005 randomized trial, 12-week response rates were 62% for ERP, 42% for clomipramine and 8% for placebo.
- Medication: SSRIs (fluoxetine, fluvoxamine, sertraline and others) are often used at higher doses and for longer than in depression; clomipramine is also used.
- Combination: a 2016 network meta-analysis concluded that combining therapy and medication is likely more effective for severe OCD.
Mindfulness-based approaches are sometimes used alongside ERP.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Does having intrusive thoughts mean I have OCD?
- Almost everyone has odd intrusive thoughts. OCD is diagnosed when they drive time-consuming rituals or cause real distress; if that sounds familiar, a mental health professional can help.
Sources reviewed: 2026-10-25
References
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
- Ruscio, A. M., et al. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63.
- Foa, E. B., et al. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162(1), 151–161.
- Skapinakis, P., et al. (2016). Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults. Lancet Psychiatry, 3(8), 730–739.