Obsessive-Compulsive Disorder - NIMH

Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts ... Skiptomaincontent Mainnavigation MentalHealthInformation GetInvolved Research Funding News&Events AboutUs HealthTopics NIMHoffersexpert-reviewedinformationonmentaldisordersandarangeoftopics. Statistics NIMHstatisticspagesincludestatisticsontheprevalence,treatment,andcostsofmentalillnessforthepopulationoftheUnitedStates. BrochuresandFactSheets Download,read,andorderfreeNIMHbrochuresandfactsheetsaboutmentaldisordersandrelatedtopics. HelpforMentalIllnesses Ifyouorsomeoneyouknowhasamentalillness,therearewaystogethelp.Usetheseresourcestofindhelpforyourself,afriend,orafamilymember. ClinicalTrials Ifyouorafriendorfamilymemberarethinkingabouttakingpartinclinicalresearch,thispagecontainsbasicinformationaboutclinicaltrials. 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QuickLinks ContributetoMentalHealthResearch Mobilenavigation MentalHealthInformation MentalHealthInformationHome HealthTopics Statistics BrochuresandFactSheets HelpforMentalIllnesses ClinicalTrials GetInvolved GetInvolvedHome StakeholderEngagement ConnectwithNIMH DigitalShareables ScienceEducation UpcomingObservancesandRelatedEvents Research ResearchHome ResearchFundedbyNIMH ResearchConductedatNIMH(IntramuralResearchProgram) Funding FundingHome Opportunities&Announcements StrategyforResearchGrants GrantWriting&ApprovalProcess ManagingGrants ClinicalResearch ResearchTrainingandCareerDevelopmentOpportunities SmallBusinessResearch News&Events News&EventsHome ScienceNews ResearchHighlights MeetingsandEvents Multimedia SocialMedia PressResources EmailUpdates InnovationSpeakerSeries AboutUs AboutUsHome AbouttheDirector AdvisoryBoardsandGroups StrategicPlan OfficesandDivisions Budget CareersatNIMH StaffDirectories GettingtoNIMH HealthTopics Statistics BrochuresandFactSheets HelpforMentalIllnesses ClinicalTrials Home > MentalHealthInformation > HealthTopics SharePage         Menu Overview SignsandSymptoms RiskFactors TreatmentsandTherapies JoinaStudy LearnMore Obsessive-CompulsiveDisorder Overview Obsessive-compulsivedisorder(OCD)isacommon,chronic,andlong-lastingdisorderinwhichapersonhasuncontrollable,reoccurringthoughts("obsessions")and/orbehaviors("compulsions")thatheorshefeelstheurgetorepeatoverandover. SignsandSymptoms PeoplewithOCDmayhavesymptomsofobsessions,compulsions,orboth.Thesesymptomscaninterferewithallaspectsoflife,suchaswork,school,andpersonalrelationships. Obsessionsarerepeatedthoughts,urges,ormentalimagesthatcauseanxiety.Commonsymptomsinclude: Fearofgermsorcontamination Unwantedforbiddenortaboothoughtsinvolvingsex,religion, orharm Aggressivethoughtstowardsothersorself Havingthingssymmetricalorinaperfectorder CompulsionsarerepetitivebehaviorsthatapersonwithOCDfeelstheurgetodoinresponsetoanobsessivethought.Commoncompulsionsinclude: Excessivecleaningand/orhandwashing Orderingandarrangingthingsinaparticular,preciseway Repeatedlycheckingonthings,suchasrepeatedlycheckingtoseeifthedoorislockedorthattheovenisoff Compulsivecounting Notallritualsorhabitsarecompulsions.Everyonedoublechecksthingssometimes.ButapersonwithOCDgenerally: Can'tcontrolhisorherthoughtsorbehaviors,evenwhenthosethoughtsorbehaviorsarerecognizedasexcessive Spendsatleast1houradayonthesethoughtsorbehaviors Doesn’tgetpleasurewhenperformingthebehaviorsorrituals,butmayfeelbriefrelieffromtheanxietythethoughtscause Experiencessignificantproblemsintheirdailylifeduetothesethoughtsorbehaviors SomeindividualswithOCDalsohaveaticdisorder.Motorticsaresudden,brief,repetitivemovements,suchaseyeblinkingandothereyemovements,facialgrimacing,shouldershrugging,andheadorshoulderjerking.Commonvocalticsincluderepetitivethroat-clearing,sniffing,orgruntingsounds. Symptomsmaycomeandgo,easeovertime,orworsen.PeoplewithOCDmaytrytohelpthemselvesbyavoidingsituationsthattriggertheirobsessions,ortheymayusealcoholordrugstocalmthemselves.AlthoughmostadultswithOCDrecognizethatwhattheyaredoingdoesn’tmakesense,someadultsandmostchildrenmaynotrealizethattheirbehaviorisoutoftheordinary.ParentsorteacherstypicallyrecognizeOCDsymptomsinchildren. IfyouthinkyouhaveOCD,talktoyourhealthcareprovideraboutyoursymptoms.Ifleftuntreated,OCDcaninterfereinallaspectsoflife. RiskFactors OCDisacommondisorderthataffectsadults,adolescents,andchildrenallovertheworld.Mostpeoplearediagnosedbyaboutage19,typicallywithanearlierageofonsetinboysthaningirls,butonsetafterage35doeshappen.ForstatisticsonOCDinadults,pleaseseetheNIMHObsessive-CompulsiveDisorderwebpage. ThecausesofOCDareunknown,butriskfactorsinclude: Genetics Twinandfamilystudieshaveshownthatpeoplewithfirst-degreerelatives(suchasaparent,sibling,orchild)whohaveOCDareatahigherriskfordevelopingOCDthemselves.Theriskishigherifthefirst-degreerelativedevelopedOCDasachildorteen.OngoingresearchcontinuestoexploretheconnectionbetweengeneticsandOCDandmayhelpimproveOCDdiagnosisandtreatment. BrainStructureandFunctioning ImagingstudieshaveshowndifferencesinthefrontalcortexandsubcorticalstructuresofthebraininpatientswithOCD.ThereappearstobeaconnectionbetweentheOCDsymptomsandabnormalitiesincertainareasofthebrain,butthatconnectionisnotclear.Researchisstillunderway.Understandingthecauseswillhelpdeterminespecific,personalizedtreatmentstotreatOCD. Environment Anassociationbetweenchildhoodtraumaandobsessive-compulsivesymptomshasbeenreportedinsomestudies.Moreresearchisneededtounderstandthisrelationshipbetter. Insomecases,childrenmaydevelopOCDorOCDsymptomsfollowingastreptococcalinfection—thisiscalledPediatricAutoimmuneNeuropsychiatricDisordersAssociatedwithStreptococcalInfections(PANDAS).Formoreinformation,pleasereadNIMH'sfactsheetonPANDAS. TreatmentsandTherapies OCDistypicallytreatedwithmedication,psychotherapy,oracombinationofthetwo.AlthoughmostpatientswithOCDrespondtotreatment,somepatientscontinuetoexperiencesymptoms. SometimespeoplewithOCDalsohaveothermentaldisorders,suchasanxiety,depression,andbodydysmorphicdisorder,adisorderinwhichsomeonemistakenlybelievesthatapartoftheirbodyisabnormal.Itisimportanttoconsidertheseotherdisorderswhenmakingdecisionsabouttreatment. Medication Serotoninreuptakeinhibitors(SRIs),whichincludeselectiveserotoninreuptakeinhibitors(SSRIs)areusedtohelpreduceOCDsymptoms. SRIsoftenrequirehigherdailydosesinthetreatmentofOCDthanofdepressionandmaytake8to12weekstostartworking,butsomepatientsexperiencemorerapidimprovement. Ifsymptomsdonotimprovewiththesetypesofmedications,researchshowsthatsomepatientsmayrespondwelltoanantipsychoticmedication.AlthoughresearchshowsthatanantipsychoticmedicationmayhelpmanagesymptomsforpeoplewhohavebothOCDandaticdisorder,researchontheeffectivenessofantipsychoticstotreatOCDismixed. Ifyouareprescribedamedication,besureyou: Talkwithyourhealthcareproviderorapharmacisttomakesureyouunderstandtherisksandbenefitsofthemedicationsyou'retaking. Donotstoptakingamedicationwithouttalkingtoyourhealthcareproviderfirst.Suddenlystoppingamedicationmayleadto"rebound"orworseningofOCDsymptoms.Otheruncomfortableorpotentiallydangerouswithdrawaleffectsarealsopossible. Reportanyconcernsaboutsideeffectstoyourhealthcareproviderrightaway.Youmayneedachangeinthedoseoradifferentmedication. ReportserioussideeffectstotheU.S.FoodandDrugAdministration(FDA)MedWatchAdverseEventReportingprogramonlineorbyphoneat1-800-332-1088.Youoryourhealthcareprovidermaysendareport. OthermedicationshavebeenusedtotreatOCD,butmoreresearchisneededtoshowthebenefitoftheseoptions.Forbasicinformationaboutthesemedications,youcanvisittheNIMHMentalHealthMedicationswebpage.Forthemostup-to-dateinformationonmedications,sideeffects,andwarnings,visittheFDAwebsite. Psychotherapy PsychotherapycanbeaneffectivetreatmentforadultsandchildrenwithOCD.Researchshowsthatcertaintypesofpsychotherapy,includingcognitivebehaviortherapy(CBT)andotherrelatedtherapies(e.g.,habitreversaltraining)canbeaseffectiveasmedicationformanyindividuals.ResearchalsoshowsthatatypeofCBTcalledExposureandResponsePrevention(EX/RP)—spendingtimeintheverysituationthattriggerscompulsions(e.g.touchingdirtyobjects)butthenbeingpreventedfromundertakingtheusualresultingcompulsion(e.g.handwashing)—iseffectiveinreducingcompulsivebehaviorsinOCD,eveninpeoplewhodidnotrespondwelltoSRImedication. Aswithmostmentaldisorders,treatmentisusuallypersonalizedandmightbeginwitheithermedicationorpsychotherapy,orwithacombinationofboth.Formanypatients,EX/RPistheadd-ontreatmentofchoicewhenSRIsorSSRIsmedicationdoesnoteffectivelytreatOCDsymptomsorviceversaforindividualswhobegintreatmentwithpsychotherapy. OtherTreatmentOptions In2018,theFDAapprovedTranscranialMagneticStimulation(TMS)asanadjunctinthetreatmentofOCDinadults. NIMHissupportingresearchintoothernewtreatmentapproachesforpeoplewhoseOCDdoesnotrespondwelltotheusualtherapies.Thesenewapproachesincludecombinationandadd-on(augmentation)treatments,aswellasnoveltechniquessuchasdeepbrainstimulation.YoucanlearnmoreaboutbrainstimulationtherapiesontheNIMHwebsite. FindingTreatment Forgeneralinformationonmentalhealthandtolocatetreatmentservicesinyourarea,calltheSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)TreatmentReferralHelplineat1-800-662-HELP(4357).SAMHSAalsohasa BehavioralHealthTreatmentLocator onitswebsitethatcanbesearchedbylocation.YoucanalsovisittheNIMH’sHelpforMentalIllnessespageformoreinformationandresources. JoinaStudy Clinicaltrialsareresearchstudiesthatlookatnewwaystoprevent,detect,ortreatdiseasesandconditions.Thegoalofclinicaltrialsistodetermineifanewtestortreatmentworksandissafe.Althoughindividualsmaybenefitfrombeingpartofaclinicaltrial,participantsshouldbeawarethattheprimarypurposeofaclinicaltrialistogainnewscientificknowledgesothatothersmaybebetterhelpedinthefuture. ResearchersatNIMHandaroundthecountryconductmanystudieswithpatientsandhealthyvolunteers.Wehavenewandbettertreatmentoptionstodaybecauseofwhatclinicaltrialsuncoveredyearsago.Bepartoftomorrow’smedicalbreakthroughs.Talktoyourhealthcareprovideraboutclinicaltrials,theirbenefitsandrisks,andwhetheroneisrightforyou. Tolearnmoreorfindastudy,visit: NIMH’sClinicalTrialswebpage:Informationaboutparticipatinginclinicaltrials Clinicaltrials.gov:CurrentStudiesonOCD:ListofclinicaltrialsfundedbytheNationalInstitutesofHealth(NIH)beingconductedacrossthecountry LearnMore FreeBookletsandBrochures Obsessive-CompulsiveDisorder:WhenUnwantedThoughtsTakeOver:ThisbrochureprovidesinformationonOCDincludingsignsandsymptoms,causes,andtreatmentoptionssuchaspsychotherapyandmedication.Alsoavailableenespañol. FederalResources Obsessive-CompulsiveDisorder(MedlinePlus–alsoenespañol) ResearchandStatistics JournalArticles:ThiswebpageprovidesinformationonreferencesandabstractsfromMEDLINE/PubMed(NationalLibraryofMedicine). OCDStatistics:Adults:ThiswebpagelistsinformationontheprevalenceofOCDamongadults. LastReviewed:September2022 Unlessotherwisespecified,NIMHinformationandpublicationsareinthepublicdomainandavailableforusefreeofcharge.CitationofNIMHisappreciated.PleaseseeourCitingNIMHInformationandPublicationspageformoreinformation. FeaturedPublicationsAboutOCD Obsessive-CompulsiveDisorder:WhenUnwantedThoughtsorRepetitiveBehaviorsTakeOver Thisbrochureprovidesinformationonobsessive-compulsivedisorder(OCD)includingsignsandsymptoms,causes,andtreatmentoptionssuchaspsychotherapyandmedication. More