Obsessive-Compulsive Disorder



  • Obsessive-compulsive disorder (OCD) is a psychiatric illness manifested by recurrent and persistent obsessions and compulsions.
  • Obsessions are defined as intrusive, unwanted thoughts, images, or impulses that cause the patient distress, and attempts are made to ignore or suppress these thoughts.
  • Compulsions are repetitive actions that patient feels driven to perform in response to an obsession. The behaviors are aimed at preventing or reducing anxiety or distress or preventing some dreaded event or situation.
    • It is not necessary that children recognize these thoughts or behaviors to be excessive or unreasonable.
    • The obsessions or compulsions cause marked distress, are time consuming (>1 hour daily), and cause impairment in daily functioning.
    • Not attributed to physiologic effects of a substance nor are explained by another mental disorder
    • Specified as “with good or fair insight,” “with poor insight,” “with absent insight/delusional beliefs,” or tic-related


  • OCD can start at any time from preschool to adulthood.
  • Although OCD does occur at earlier ages, there are generally two age ranges when OCD first appears. The first range is between ages 10 and 12 years and the second between the late teens and early adulthood.

Risk Factors

  • Familial heritability pattern
  • Moderate genetic component based on twin studies
  • Acute streptococcal infection (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections [PANDAS])

Commonly Associated Conditions

  • Depression
  • Anxiety disorders
  • Tourette syndrome
  • Trichotillomania

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