What is obsessive compulsive disorder (OCD)?

Obsessive compulsive disorder (OCD) is a mental health condition characterised by obsessions and compulsions. This disorder involves a cycle where intrusive thoughts create anxiety, leading individuals to perform specific actions in an attempt to reduce that distress or make the thoughts go away.

Symptoms of OCD

The core symptoms of OCD revolve around obsessions and compulsions.

Obsessions

Obsessions are intrusive, unwanted thoughts, images, or urges that repeatedly enter a person's mind and cause significant anxiety or distress.

Compulsions

Compulsions are acts performed in an attempt to prevent obsessive thoughts or make them go away. These actions can temporarily ease tension, but the relief is fleeting.

Common compulsive behaviours and their purpose

Examples of common compulsive behaviours

• Checking
• Washing
• Repeating
• Hoarding
• Rearranging
• Counting

These behaviours are generally carried out to ward off harm to the person with OCD or others. Some individuals develop highly regimented rituals, where tasks must be done in an exact sequence each time. This structured approach might offer momentary anxiety relief, but it reinforces the compulsion and can disrupt normal activities.

Prevalence and onset of OCD

Prevalence rates

• In adults, the prevalence of OCD ranges from 0.8 to 3 per cent.
• Among children and adolescents, rates range from 0.25 to 2 per cent.
• Based on UK population estimates, approximately 741,504 people may be living with OCD at any given time.
• Severity distribution shows that about 50 per cent of cases are severe, while less than a quarter are mild.

Onset patterns

OCD most commonly begins in late adolescence or early twenties, but it can develop at any age.

Impact of OCD on quality of life

Key impacts

• Disability ranking - The World Health Organization (WHO) ranks OCD among the top ten most disabling illnesses worldwide.
• Economic effects - It contributes to lost earnings.
• Quality of life reduction - It leads to diminished quality of life.

Diagnostic criteria for OCD

Requirements for diagnosis

• Obsessional symptoms (intrusive thoughts) or compulsive acts, or both, must be present on most days for at least two successive weeks.
• These symptoms must cause distress or interfere with daily activities.
• At least one hour per day must be spent on the obsessive thoughts and compulsive rituals.