Obsessive-Compulsive Disorder (OCD) Obsessive-Compulsive Disorder (OCD)

A person with obsessive-compulsive disorder (OCD) experiences recurring, unwanted images or impulses (obsessions) and feels an urge to do something that will relieve the discomfort caused by the obsession (compulsions). Obsessive-compulsive disorder affects about 1.5% of the population in any given 6-month period and is equally common among men and women. OCD is a psychiatric illness that affects daily life and social functioning, and should not be confused with the less disabling obsessive-compulsive personality disorder (see below).

Obsessions in OCD are usually associated with a sense of danger, harm, or risk. Common obsessions in OCD include concerns about contamination, doubt or worry, fear of loss, and fear of aggression. There can also be pervasive need to count or keep ordered objects that most people do not pay particular attention to, such as the number of cars passing an intersection or the way clothes are organized in a drawer.

More than 95% of people with obsessive-compulsive disorder feel the need to perform rituals to control their obsessions. The repetitive, intentional acts associated with OCD include washing or cleaning to avoid contamination, hoarding to prevent loss, and repeated checking to be sure a door is locked to alleviate doubt. Most OCD rituals can be observed; other rituals, such as repetitive counting, cannot.

Most people with obsessive-compulsive disorder realize that their obsessive thoughts do not reflect actual risks and that their compulsive rituals are ineffective. Thus OCD differs from psychotic disorders, in which people have an altered perception of reality. OCD also differs from obsessive-compulsive personality disorder. Unlike OCD, obsessive-compulsive personality disorder does not involve unwanted, repetitive thoughts and ritualistic behaviors. People with obsessive-compulsive personality disorder are preoccupied with perfection, order, and control. They are methodical and dependable, but their personality inhibits their adapting to change or making decisions readily.

In addition, nearly one third of patients with obsessive-compulsive disorder are also diagnosed with coexisting depression.

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