Obsessive-compulsive disorders
Obsessive-Compulsive Disorder (OCD)
OCD involves intrusive, unwanted obsessions, compulsions performed to reduce distress, or both; it is not a preference for order or perfection.
Obsessions and compulsions
Obsessions may concern contamination, harm, responsibility, taboo themes, religion, relationships or a need for certainty or symmetry. Their content does not reveal a person’s wishes or character. Compulsions can be visible—washing, checking, arranging—or mental, such as reviewing, counting, neutralising or repeatedly seeking reassurance.
A compulsion may relieve anxiety briefly, but reinforces the cycle. Some people recognise that the feared outcome is unlikely; others have less insight. Shame often delays help.
Assessment
A clinician assesses the nature, time cost, distress and impact of obsessions and compulsions. Differential assessment may include generalized worry, psychosis, depression, autism, tics, body dysmorphic concerns, eating disorders and obsessive-compulsive personality traits. Intrusive thoughts alone are common; OCD is about the persistent cycle and impairment.
Evidence-based treatment
CBT with exposure and response prevention (ERP) is a first-line psychological treatment. Exposure is gradual and collaborative; response prevention means learning not to complete the ritual or reassurance cycle. Medication, particularly certain antidepressants, may be prescribed and monitored by a doctor. Severe or complex presentations may need specialist care.