Obsessive-Compulsive Disorder

JAMA. 2011;305(18):1926. doi: 10.1001/jama.305.18.1926  

Sharon Parmet, MS, Writer; et al.

Obsessive-compulsive disorder (OCD) is an anxiety disorder ...
This Patient Page is based on one published in the October 27, 2004, issue of JAMA.

Obsessive-compulsive disorder is characterized by the presence of obsessions or compulsions or (as is often the case) both of them. The obsessions or compulsions cause marked distress, are time-consuming, and interfere with the person's normal functioning.

Obsessions—unwanted, recurrent thoughts, impulses, or images that are experienced as intrusive and inappropriate

• The obsessions of OCD are not just worries about real-life problems.
• The person realizes that the obsessive thoughts are from his or her own mind.
• The person attempts to suppress or neutralize the obsessions with actions or other thoughts.
• Examples of typical obsessions include thoughts of being contaminated by dirt or germs or thoughts of having hurt someone, even though recognizing that such concerns are not realistic.

Compulsions—repetitive behaviors or "rituals" that the person feels driven to perform in a particular way

• The compulsive actions are done to reduce distress or to prevent something bad from happening, even though there is no realistic connection with preventing such an occurrence.
• Typical compulsions include excessive cleaning (such as hand washing), repetitive checking, and hoarding of useless items.
• Mental acts such as praying, counting, or repeating words silently can be compulsions for some persons./.../