What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a mental health condition that involves unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that are meant to ease distress or prevent a feared outcome.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) — a guide mental health professionals use to diagnose conditions — OCD symptoms must be time consuming, cause serious distress or impairment, and not be better explained by another condition.
OCD often co-occurs along with anxiety, depression and trauma. This can make symptoms harder to recognize and more difficult to manage without the right support.
Read about the types of OCD here.
How common is OCD? Key prevalence stats
More than one in four people experience intrusive thoughts or repetitive behaviors, but that doesn’t mean they have OCD.[1] Only a small percentage meet the criteria for a diagnosis. Let’s look at the numbers:
About 2.3% of people meet diagnostic criteria for OCD at some point in their lives.[1]
Around 1.2% meet the criteria within a given year.[1]
Who gets OCD? Stats by age, gender and life stage
OCD can affect anyone, but when and how it shows up often depends on age and gender — and who it impacts most can change over time. Here are some recent stats:
OCD most commonly appears around age 19, and about one in four cases start by age 14.[2]
Among children and adolescents, boys are more likely to be diagnosed with OCD than girls.[3]
A study of 71 children and adolescents with OCD (average age 12.7 years) found that older teens were more likely to experience depression than younger individuals. Depression was also linked to more severe OCD symptoms.[3]
In adulthood, women are 1.6 times more likely to have OCD than men.[4]
Is OCD genetic? Family risk and heredity
Research shows that OCD can run in families, suggesting a strong genetic link. Key stats include the following:
In a study of 100 individuals and 466 of their first-degree relatives, researchers found that people were more likely to have OCD — or subclinical symptoms — if a first-degree relative also had OCD.[5]
In children with OCD, there is a 26% risk of OCD in a first-degree relative. In adults with adult-onset OCD, there is a 12% risk of OCD in a first-degree relative.[6]
A large Swedish study of over 2.4 million people found that OCD was largely inherited — and that one’s environment is less impactful than one’s genes in determining who develops it.[7]
OCD and co-occurring disorders: Depression, ADHD and more
OCD often shows up alongside other mental health conditions. These co-occurring disorders can vary by age and may include anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), eating disorders and more. Here’s what the research shows:
Adults with OCD often experience co-occurring mood and anxiety disorders.[8].
Most children and adolescents with OCD have at least one co-occurring mental health condition, which may include:
ADHD
Tic disorders
Oppositional defiant disorder
Autism spectrum disorders
Disruptive mood dysregulation disorder[6]
OCD is also linked to eating disorders. In a study of 741 individuals with eating disorders, 41% also met diagnostic criteria for OCD [9]. A recent review of the literature indicates that approximately one-fifth of patients with eating disorders also have a diagnosis of OCD.[10]
Childhood trauma may contribute to the development of OCD, with some research suggesting a link between OCD, OCD symptom severity, and a history of early abuse.[11,12]
OCD and ADHD: A frequent overlap
OCD and ADHD often show up together, and when they do, symptoms can be more intense and complex. Research findings show the following:
In a study of 100 adults with OCD, nearly half had childhood ADHD symptoms.[13]
An estimated 30% of individuals with OCD may have adult ADHD.[13]
ADHD is one of the most common co-occurring conditions in people with early-onset OCD.[14]
In a study of 93 adults with OCD in Japan, those with both OCD and ADHD:
Had an earlier onset of OCD
Were more likely to experience hoarding, anxiety and depression
Reported a lower quality of life, and
Were more likely to have substance or behavioral addiction.[15]
The link between OCD and depression
Major depressive disorder (MDD) is the most common co-occurring mental health condition associated with OCD.[16] People with OCD and depression often report more severe symptoms, making daily life even more challenging. According to recent research:
Approximately half of those with OCD also have depression.[16]
One study found that adults with both OCD and depression have more severe obsessive and compulsive symptoms than those without depression.[16]
In a study of 140 adults with OCD — 63 had MDD and 77 did not — researchers found that anxiety, depression, and obsession and compulsion symptom scores were significantly higher in those with both conditions.[16]
OCD and anxiety: How these conditions overlap
Anxiety is common in children, adolescents and adults with OCD. When the two conditions occur together, symptoms can be even harder to manage. Let’s look at the numbers:
After depression, anxiety disorders are the second most common co-occurring condition in people with OCD.[8]
In a study of 140 adults with OCD, 16.3% also had an anxiety disorder[16].
In a study of 71 children and adolescents with OCD (average age 12.7 years), nearly half of the participants had at least one anxiety disorder.[3]
Can you have OCD without compulsions?
Compulsions (repetitive behaviors or mental acts done to reduce anxiety or prevent a feared outcome) are almost always present in OCD. Even if they aren’t outwardly visible, research shows that people often experience compulsions in covert forms.[17]Here’s what the data shows:
One study of 1,086 individuals in residential or intensive outpatient treatment for OCD found that all participants had both obsessions and compulsions. For some, compulsions were more “covert,” including mental rituals and reassurance-seeking behaviors.[18]
In another study of 201 individuals with OCD, every participant experienced mental compulsions and/or reassurance-seeking behaviors.[17]
OCD rituals: Checking, cleaning and more
Rituals (compulsions repeated excessively or performed in a specific way to reduce distress) are a big part of OCD for many people. While not everyone has the same types of compulsions, ritual behaviors — like checking, cleaning or ordering — are very common. Studies reveal:
Rituals are one of the most common features of OCD. A large study of adults with OCD found that behaviors like checking, cleaning, repeating and arranging were especially prevalent.[19].
In a study of 485 adults with OCD, researchers noted the frequency of the following ritual-type behaviors:
Checking rituals: 72.8%
Cleaning rituals: 59.2%
Repeating rituals: 51.5%
Ordering and arranging rituals: 50%
Counting rituals: 33.5%[19]
OCD and cleaning rituals: Why they’re so common
Many people with OCD feel compelled to clean frequently to reduce anxiety or prevent perceived harm. Here’s what the research shows:
Cleaning is one of the most common compulsive behaviors in people with OCD.[19]
In a study of 485 adults with OCD, nearly 60% regularly engaged in cleaning rituals.[19]
Magical thinking and OCD: What is it?
Magical thinking, the belief that thoughts or actions can influence unrelated outcomes, is a common feature of OCD. Experts believe that it may provide individuals with a perceived sense of control over their lives, especially during stressful situations.
Here’s what the data shows:
Magical thinking may be a “central cognitive feature” of OCD, occurring when someone believes that certain thoughts or behaviors can influence future events.[20]
Some experts suggest it may be a way to cope with stress or regain control during highly challenging situations.[21]
OCD, hand washing and germ fears
One of the most common obsessions in OCD is fear of contamination, which often leads to compulsive hand washing or cleaning as a way to feel safer or less anxious — especially during periods of heightened stress.
Recent studies reveal:
The COVID-19 pandemic likely led to an increase in obsessive and compulsive symptoms in young people in 2020.[22]
A study of 1,220 individuals in Germany found an increase in contamination-related obsessive-compulsive symptoms during the early months of the pandemic. However, these symptoms decreased by the end of the first year.[23]
Devices that collect personal data, including smart bands and smartwatches, may help those with OCD. A small study of 82 individuals found a smartwatch capable of automatically detecting compulsive hand washing was moderately useful in combination with cognitive behavioral therapy.[24]
OCD and hoarding: How ADHD fits in
Hoarding refers to having a hard time getting rid of things, even if they aren’t useful or valuable. Hoarding is considered a subtype of OCD — and may be even more common when ADHD is also present. Here’s what the data shows:
There is a strong association between ADHD and hoarding behaviors in individuals with OCD.[25]
The link between hoarding, OCD and ADHD may involve family history and be related to executive functioning impairment.[25]
The best OCD treatments: CBT and ERP
The most effective treatment for OCD is cognitive behavioral therapy (CBT), a skills-based approach that helps people change unhelpful thought patterns and behaviors.
A form of CBT called exposure and response prevention (ERP) involves gradually facing feared situations while resisting the urge to engage in compulsions. Research shows that ERP is effective for people of all ages with OCD.[26,27]Let’s look at the numbers:
Multiple studies showed that ERP therapy is as effective as, if not more effective than, medication for treating OCD in adults.[27]
About 75% of adults with OCD experience improvement with ERP.[28]
A clinical trial with 334 adults found that 22.5% showed dramatic improvement with a standardized course of ERP, 52.1% showed moderate improvement and 25.4% showed little change.[28]
A meta-analysis of over 1,100 patients found that ERP combined with medication is significantly more effective than medication alone.[29]
For children and adolescents, studies showed the combination of ERP and medication (serotonin reuptake inhibitors or SSRIs) provides more relief than ERP alone.[27]
Living with OCD: The day-to-day impact
OCD-related behaviors can take up a lot of time. One goal of OCD treatment is to reduce the time spent on obsessions and compulsions — freeing up time for other valued activities. Studies reveal the following:
OCD symptoms interfere with daily life, meaning that day-to-day activities take longer to perform (e.g., leaving the house or cleaning a room). This means there is less time for other things that people may want to do because the symptoms are so time consuming.[30]
In a study comparing 299 people in inpatient treatment for OCD with 300 people without OCD, researchers found those with OCD spent more time on daily activities than those without the condition, even when the activities were not part of their core OCD symptoms.[30]
Why OCD statistics matter
Understanding the numbers helps shine a light on what it’s really like to live with OCD — and reminds us that no one is alone.
These stats can help reduce stigma, validate lived experience and encourage more people to seek the treatment they deserve. OCD is highly treatable, and hope is never out of reach.
You don’t have to face OCD alone
If you or someone you love is struggling with OCD, help is available. Pathlight Mood & Anxiety Center offers personalized care through our specialized OCD track — with treatment options for children, adolescents and adults.
Need support for OCD? Call 1-877-711-1878 or schedule a free assessment today. Specialized care for children, teens and adults is just a call away.