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Obsessive-compulsive disorder or OCD (obsessive-compulsive disorder) is an anxiety disorder that centers around recurrent obsessions or compulsions. Often one has both obsessions and compulsions, and often obsessions are the basis for the compulsions. 

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Symptoms of obsessive-compulsive disorder

Obsessive-compulsive disorder - or obsessive-compulsive disorder (OCD) - is described in the ICD-10 diagnostic manual as follows [ICD-10][1] :

The main feature is recurring obsessions or compulsions. Obsessive thoughts are ideas, perceptions or impulses that repeatedly appear in the patient's consciousness in a stereotypical form. They are almost invariably disturbing, and the patient often tries, without success, to resist them. However, the patient acknowledges them as their own thoughts, even if they are involuntary and often repulsive.

Coercive acts or coercive rituals are stereotyped behaviors that are repeated over and over again. They are not in themselves pleasant or useful. The purpose is to prevent some objectively improbable event which causes harm to, or which is caused by, the patient, and which he or she otherwise fears will occur. Usually, this behavior is recognized by the patient as meaningless or useless, and he or she therefore makes repeated attempts to resist it. Anxiety is almost always present. If the coercive actions [compulsive rituals] are resisted, the anxiety gets worse.


Obsessive thoughts

The most common obsessions are about fear...


  1. become infected or infect others with a dangerous disease
  2. ...that one has forgotten something important and that this can cause, for example, fire or burglary
  3. ...that other accidents may occur


Others may be bothered by thoughts of sexual content that are perceived as blasphemous, and thoughts of performing actions that may harm someone they love.

The thoughts are not pleasurable, and it is not something you want to do. When thoughts appear, this causes intense discomfort and fear that there may be a real risk associated with having such thoughts.


Compulsive actions

In order to alleviate the discomfort caused by the obsessive thoughts and to ensure that the negative events do not occur, compulsive actions are performed. The most common coercive actions are:


  1. Excessive washing or checking of doors, windows or electrical appliances
  2. Excessive order, symmetry or repetition
  3. Mental rituals such as counting to specific numbers
  4. Think of positive words to neutralize negative thoughts
  5. Ask repeatedly about insurance from other people



Treatment for OCD

Importantly, research indicates that cognitive behavioral therapies (CBT) are efficient [Olatunji et al., 2013][2] . Exposure with response prevention is a common ingredient in the therapy [Rosa-Alcázar et al., 2008][3] .

Below are some helpful videos that gives important perspective on treatment and self-help principles related to OCD.


The Bergen 4-day Treatment (B4DT) for OCD


Self-help principles for OCD


Different forms of help

Several types of help may have benefits for individuals that struggle with OCD. These are some of your options:


  1. Psychotherapy




    Psychotherapy / treatment is a process characterized by a time-limited contact between a therapist and a patient / client, in which specific problems are thematized and worked with. Include different therapeutic traditions (for example cognitive behavioral therapy (CBT), psychodynamic therapy, family therapy, and more)

    A useful source that evaluate the effectiveness of specific therapies for different mental health problems is the website to the Cochrane Institute [Cochrane Institute][4] .


  2. Online therapy




    Online therapy is similar to traditional therapy or treatment, but is provided by digital means (either phone, video conference, or similar). Digital interventions can include a broader range of options, such as therapist-guided self-help programs online.

    The current research literature provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity [Barak et al., 2008][5] .


  3. Support / self-help groups




    Support / self-help groups can take a variety of forms, from providing a safe and supportive social environment; more or less structured group meetings; information and guidance relating to how to use available help services; and a lot more.

    While it is difficult to know the effectiveness of such services, due to very different compositions of support and self-help services, the research generally show the self-help groups may have important benefits for the participants [Kurouz et al., 2002][6] .


  4. Helplines and chats




    Different helplines and chats exist. Some helplines are specialized in providing you with information and guidance, while others are more specialized in providing emotional support. Some helplines are highly professional, while others are more based on voluntary workers, that merely wish to be a caring listener.

    It is difficult to evalute how effective such services are, and it probably depends on many factors. For example, while the state of the science regarding the effectiveness of crisis response services remains limited, overall results provide support for such services [Hoffberg et al, 2020][7] .


  5. Online communities and forums




    Online communities and forums are options to get in contact with other individuals that struggle with something similar to you or someone you know. Some communities are moderated by professional health workers, while most of them are not.

    Online communities is traditionally not understood as a support or health service, but rather a social area - that may have the potential of being supportive for the individual that uses it. Importantly, research has shown that "people with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours" [Naslund et al., 2016][8] .

    This seems to indicate that online communites should not be underevaluated as a potential resource to recovery, coping and enhanced quality of life for people affected by mental health problems.



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References & Footnotes
  1. ICD-10: World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research (Vol. 2). World Health Organization.
  2. Olatunji et al., 2013: Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal of psychiatric research47(1), 33-41.
  3. Rosa-Alcázar et al., 2008: Rosa-Alcázar, A. I., Sánchez-Meca, J., Gómez-Conesa, A., & Marín-Martínez, F. (2008). Psychological treatment of obsessive–compulsive disorder: A meta-analysis. Clinical psychology review28(8), 1310-1325.
  4. Cochrane Institute: Cochrane Institute: "Trusted evidence. Informed decisions. Better health." Retrieved 9th of February 2020 from:
  5. Barak et al., 2008: Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. A. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human services26(2-4), 109-160.
  6. Kurouz et al., 2002: Kyrouz, E. M., Humphreys, K., & Loomis, C. (2002). A review of research on the effectiveness of self-help mutual aid groups. British Journal of Clinical Psychology33, 198-200.
  7. Hoffberg et al, 2020: Hoffberg, A. S., Stearns-Yoder, K. A., & Brenner, L. A. (2020). The effectiveness of crisis line services: A systematic review. Frontiers in public health7, 399.
  8. Naslund et al., 2016: Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., & Bartels, S. J. (2016). The future of mental health care: peer-to-peer support and social media. Epidemiology and psychiatric sciences25(2), 113-122.