OCD risk factors: what raises the chance of obsessive-compulsive disorder

What OCD is

OCD is a long-lasting disorder in which a person has uncontrollable and recurring thoughts (obsessions), repetitive behaviors (compulsions), or both. The symptoms take up time and can cause significant distress or get in the way of daily life, but treatment can help people manage them (NIMH). MedlinePlus notes that it is a myth that OCD just means being neat: cleaning can be one symptom, but OCD more often involves getting stuck on an action you feel compelled to repeat (MedlinePlus).

There is no score or calculator on this page; the factors below are the ones NIMH and MedlinePlus name.

Who is more likely to develop OCD

The exact causes of OCD are unknown, but various risk factors increase the chance of developing it (NIMH). MedlinePlus says genetics, brain biology and chemistry, and environment may play a role (MedlinePlus).

• Family history. Having a first-degree relative (a parent, sibling or child) with OCD is linked to a higher chance of developing it (NIMH) (MedlinePlus), especially if the relative developed OCD as a child or teen (MedlinePlus). No single gene or set of genes has been found that definitely leads to OCD (NIMH).
• Brain structure and function. Brain imaging studies show that people with OCD often have differences in the frontal cortex and in deeper (subcortical) brain structures, areas that affect control of behavior and emotional responses (NIMH).
• Temperament. People who were more reserved, had more negative emotions, or showed symptoms of anxiety and depression as children are more likely to develop OCD (NIMH) (MedlinePlus).
• Childhood trauma. Some studies have found a link between trauma in childhood, such as child abuse, and OCD symptoms; more research is needed (NIMH) (MedlinePlus).
• Strep infection in children (PANDAS). Children who suddenly develop OCD symptoms, or whose symptoms get worse, after a streptococcal infection may be diagnosed with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) (NIMH) (MedlinePlus).

When it usually starts

OCD symptoms can begin at any time but usually start between late childhood and young adulthood, and most people are diagnosed as young adults (NIMH). Boys are often diagnosed at a younger age than girls (MedlinePlus). Symptoms may start slowly, can ease for a while or worsen over time, and often get worse during times of stress (NIMH).

Signs and symptoms

People with OCD may have obsessions, compulsions, or both (NIMH):

• Common obsessions: fear of germs or contamination; fear of forgetting, losing or misplacing something; fear of losing control over one's behavior; aggressive thoughts toward others or oneself; unwanted or taboo thoughts involving sex, religion or harm; and wanting things symmetrical or in perfect order.
• Common compulsions: excessive cleaning or handwashing; ordering or arranging items in a precise way; repeatedly checking things, such as whether the door is locked or the oven is off; compulsive counting; and praying or repeating words silently.

Everyone double-checks things sometimes. NIMH says people with OCD generally cannot control their obsessions or compulsions even when they know they are excessive, spend more than 1 hour a day on them, get no pleasure from the compulsions (though they may feel brief relief from anxiety), and have significant problems in daily life because of them (NIMH).

Some people with OCD also have a tic disorder, and it is common for people with OCD to also have a mood disorder or an anxiety disorder (NIMH). See anxiety risk factors and depression risk factors.

Treatment and getting help

Treatment helps many people, even those with the most severe forms of OCD. There is no cure, but treatment with psychotherapy, medication or both helps people manage symptoms and lead full, active lives (NIMH). Cognitive behavioral therapy, including exposure and response prevention, is a main treatment, and the most common medicines are antidepressants that target serotonin (NIMH) (MedlinePlus). Do not stop taking a medication without first talking to your health care provider (NIMH).

If you think you or your child may have OCD, talk to a health care provider; left untreated, OCD symptoms can become severe (NIMH).

The 988 Lifeline is free and confidential and available 24/7 (988 Lifeline).

Common questions

Is OCD genetic?

Having a parent or sibling with OCD is linked to a higher chance of it, but no single gene or set of genes has been found that definitely leads to OCD (NIMH).

At what age does OCD start?

Usually between late childhood and young adulthood; most people are diagnosed as young adults (NIMH).

Can stress make OCD worse?

Yes. NIMH says symptoms often get worse during times of stress (NIMH).