1. Criteria

Obsessions, compulsions, or both are present.

Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted.
The obsessions usually cause marked anxiety or distress.
The person attempts to ignore, suppress, or neutralize the obsessions with another thought or action.

Compulsions are repetitive behaviors such as washing, checking, or ordering, or mental acts such as praying, counting, or repeating words silently.
The compulsions are performed in response to an obsession or according to rules that must be applied rigidly.
The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or at preventing some dreaded event or situation.
The behaviors or mental acts are either not realistically connected to what they are meant to prevent or are clearly excessive.

Obsessions or compulsions are time-consuming or cause clinically significant distress or impairment.

The symptoms are not due to substances or another medical condition.

The disturbance is not better explained by another mental disorder such as GAD, body dysmorphic disorder, illness anxiety disorder, or psychosis.

2. Context

OCD usually feels to patients like getting trapped in a loop. Unwanted thoughts, urges, or images show up again and again, and the person starts doing rituals or mental acts to lower the distress, even when part of them knows the cycle does not really make sense.
Core distinction: The most useful distinction is simple: obsessions are the intrusive experiences, and compulsions are what the person does to feel safer, more certain, or less distressed.
Time and impairment: In practice, OCD starts to stand out when it is eating up time, driving avoidance, or making ordinary routines feel much harder than they should.
Treatment pairing: The usual treatment conversation pairs ERP with medication. Most medication pathways start with an SSRI, with clomipramine as another classic option.
Clinical focus: Most common clinician-rated severity scale for OCD.

3. Validated scales

Y-BOCS

Most common clinician-rated severity scale for OCD.

OCI-R

Brief self-report symptom tracking across obsession and compulsion domains.

CGI-S

Quick global severity measure for routine follow-up.

DOCS

Dimension-based self-report measure across contamination, responsibility, taboo thoughts, and symmetry.

4. FDA approved treatments

FDA-indicated monotherapy options for OCD

These are the most established FDA-labeled medications for OCD, with age-specific approvals differing by product.

Common treatment side effects

Check drugs.com/sfx for common side effects. Direct side-effect links for the medications in this section are below when available.

Common off-label medications

Interventional psychiatry modalities

Deep TMS and other neuromodulation strategies are being studied in OCD.
ECT is not a standard OCD treatment but may be used in severe comorbid states.
Ketamine is under investigation for rapid symptom reduction in OCD.

Related Guides

5. Top management articles

Drug treatment of obsessive-compulsive disorder Review literature
Exposure and response prevention for obsessive-compulsive disorder Psychotherapy literature
Practice guideline for the treatment of patients with obsessive-compulsive disorder APA guideline

When to seek professional help

Seek urgent help if there are thoughts of suicide, self-harm, or feeling unable to stay safe.³
Seek urgent help if there are thoughts of harming someone else, escalating violent urges, or loss of behavioral control.³
Take hopelessness seriously, especially if the person feels trapped, cannot imagine staying safe, or is withdrawing from support.⁴
Use emergency services if there is immediate danger, severe agitation, psychosis, intoxication, or inability to care for basic needs. In the United States, call or text 988 for crisis support and call 911 for immediate danger. Use emergency services in your region if you are outside the U.S.³

Simple Psych

Obsessive-Compulsive Disorder

1. Criteria

Criterion A

Criterion A1: Obsessions

Criterion A2: Compulsions

Criterion B

Criterion C

Criterion D