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Definition

Obsessive-compulsive disorder (OCD) is an anxiety disorder. A person with OCD has unwanted repetitive thoughts and behaviors.

Causes

The exact cause of OCD is unknown. The nervous system, environment, genes, and mental health may all play a role.

Chromosome_DNA

The genes that you inherit from your family may play a role in the development of OCD.

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Risk Factors

OCD is more common in late teens into early adulthood. Your risk is also higher if you have family with OCD.

Symptoms

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:

If you have OCD, you may know that your thoughts and compulsions do not make sense, but you are unable to stop them.

Diagnosis

Your doctor may ask you many questions about your symptoms. This will help to make a diagnosis. 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

OCD can not be cured. Treatment can reduces OCD thoughts and compulsions. Early treatment can have better results. Common treatment approaches include a combination of medication and therapy.

Medications

Medicine can help to decrease symptoms. Options may include one or more of the following:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants

It may take some time to find the best combination for you. Work with your care team to help reach your health goals.

Therapy

Therapy can help to manage habits and actions with OCD. Cognitive-behavioral therapy (CBT) is one common option.

Other examples of therapies used to treat OCD include:

  • Exposure and response prevention—involves gradually confronting the problem 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

Other therapy may be tried for OCD that does not respond to usual care. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) ha ve shown some promise. However, the se ar e not for everyone. Be sure to discuss them with your doctor.

Prevention

There are no steps for preventing OCD.

RESOURCES:

Anxiety and Depression Association of America
https://adaa.org

International OCD Foundation
https://iocdf.org

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
http://www.cpa-apc.org

REFERENCES:

Obsessive compulsive disorder (OCD). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD. Updated September 25, 2017. Accessed October 4, 2017.

Obsessive-compulsive disorder (OCD). National Institute of Mental Health, National Institutes of Health website. Available at: https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Updated January 2016. Accessed October 4, 2017.

OCD risk higher when several variations in gene occur together. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/news/science-news/2008/ocd-risk-higher-when-several-variations-in-gene-occur-together.shtml. Accessed October 4, 2017.

4/16/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD: 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(5):621-630.

7/15/2016 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD: Fontenelle LF, Coutinho ES, Lins-Martins NM, Fitzgerald PB, Fujiwara H, Yücel M. Electroconvulsive therapy for obsessive-compulsive disorder: a systematic review. J Clin Psychiatry. 2015;76(7):949-957.

11/6/2018 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD: FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. Available at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm617244.htm.

Last reviewed September 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 11/6/2018