Obsessive-Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder. A person with OCD has unwanted repetitive thoughts and behaviors.
The cause is of OCD is unknown. OCD may be due to neurobiological, environmental, genetic, and psychological factors. An imbalance of a brain chemical called serotonin may play a major role.
OCD is more common in late adolescence into early adulthood. Your risk is also higher if you have family members with a history of OCD.
OCD may cause:
Obsessions—unwanted, repetitive, and intrusive ideas, impulses, or images; common obsessions include:
- Persistent fears that harm may come to self or a loved one
- Unreasonable concern with being contaminated
- Unreasonable concerns about safety
- Unacceptable religious, violent, or sexual thoughts
- Excessive need to do things correctly or perfectly
- Persistent worries about a tragic event
Compulsions—repetitive behaviors or mental acts to reduce the distress associated with obsessions; common compulsions include:
- Excessive checking of door locks, stoves, water faucets, and light switches
- Repeatedly making lists, counting, arranging, or aligning things
- Collecting and hoarding useless objects
- Repeating routine actions a certain number of times until it feels right
- Unnecessary rereading and rewriting
- Mentally repeating phrases
- Repeatedly washing hands
Conditions associated with OCD include:
- Other anxiety disorders
- Organic brain syndrome
- Tourette syndrome
- Attention deficit disorder
If you have OCD, you may know that your thoughts and compulsions do not make sense, but you are unable to stop them.
OCD is usually diagnosed through a psychiatric assessment. OCD is diagnosed when obsessions and/or compulsions either:
- Cause significant distress
- Interfere with your ability to properly perform at work, school, or in relationships
Treatment reduces OCD thoughts and compulsions, but does not completely eliminate them. Common treatment approaches include a combination of medication and therapy.
Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting serotonin levels. Tricyclic antidepressants can also help treat symptoms.
Your doctor may try using other psychiatric medications to help control your condition.
Behavioral therapy addresses the actions associated with OCD. Cognitive-behavioral therapy (CBT) addresses both the thought processes and the actions associated with OCD.
Treatment of OCD is tailored to meet your particular needs.
Examples of therapies used to treat OCD include:
- Exposure and response prevention—involves gradually confronting the feared object or obsession without giving into the compulsive ritual linked to it
- Aversion therapy—involves using a painful stimulus to prevent OCD behavior
- Thought switching—involves learning to replace negative thoughts with positive thoughts
- Flooding—involves being exposed to an object that causes OCD behavior
- Implosion therapy—involves being repeatedly exposed to an object that causes fear
- Thought stopping—involves learning how to stop negative thoughts
There are no guidelines for preventing OCD because the cause is not known. However, early intervention may be helpful.
Anxiety Disorders Association of America
International OCD Foundation
Canadian Mental Health Association
Canadian Psychological Association
Obsessive compulsive disorder (OCD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 18, 2014. Accessed August 21, 2014.
Obsessive-compulsive disorder (OCD). National Institute of Mental Health, National Institutes of Health website. Available at: http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed August 21, 2014.
OCD risk higher when several variations in gene occur together. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/science-news/2008/ocd-risk-higher-when-several-variations-in-gene-occur-together.shtml. Accessed August 21, 2014.
4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Simpson HB, Foa EB, Liebowitz MR, et al. A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am J Psychiatry. 2008;165:621-630.
Last reviewed August 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.