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Achieving Wellness from Obsessive Compulsive Disorder is a treatment study sponsored by NIMH.

Symptoms of OCD

Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder that includes distressing, intrusive thoughts and related compulsions (tasks or "rituals") to neutralize the obsessions. Obsessions are usually upsetting and the compulsions lead to temporary feelings of relief. To be diagnosed with obsessive-compulsive disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions together. Most people with OCD have both.

Obsessions are:

  1. Recurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate. The thoughts cause severe anxiety or distress.

  2. Thoughts, impulses, or images are not just excessive worries about real-life problems.

  3. The person tries to ignore or suppress the thoughts, impulses, or images, or to neutralize them with some other thought or action.

  4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.

Compulsions are:

  1. Repetitive behaviors or mental acts that the person feels they must perform in response to an obsession, or according to rigid rules.

  2. The behaviors or mental acts to prevent or reduce distress or prevent some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are supposed to neutralize or prevent or are clearly excessive.

In addition, at some point during the course of the disorder, the person must realize that his/her obsessions or compulsions are unreasonable or excessive. The obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause difficulty in social, work, or school functioning. Having OCD is stressful and can lead to feelings of depression.


Community studies have estimated a lifetime prevalence of 2.5% and a 1-year prevalence of 0.5%-2.1% in adults. Research shows that prevalence rates of obsessive-compulsive disorder are similar in many different cultures around the world.


OCD usually begins in adolescence or early adulthood, but it may begin in childhood. Most people with OCD have a chronic waxing and waning course, with worsening of symptoms that may be related to stress. The phrase "obsessive-compulsive" has worked its way into the wider English language, and is often used in an off-hand manner to describe someone who is meticulous or absorbed in a cause. It is also important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. Although these signs are often present in OCD, a person who shows signs of infatuation or fixation with a subject/object, or displays traits such as perfectionism, does not necessarily have OCD.