OCD Symptoms

The number and types of obsessions and compulsions in OCD are quite limited and can be classified into the following major symptom groups:

• Contamination by dirt and/or germs; its accompanying compulsion is washing.  People may spend several hours each day washing their hands, showering or cleaning.  They may avoid possible sources of ‘contamination’ such as doorknobs, electric switches and newspapers.
  
• Checking arising from obsession with doubt.  People will be concerned that if they don’t check carefully enough, they may harm others.  But instead of resolving uncertainty, checking often contributes to even greater doubt, which leads to further checking.  Family and friends may help ensure the thoroughness of the checking.
  
• Pure obsessions in which people experience repetitive, intrusive thoughts which are usually aggressive or sexual, and are always reprehensible to the person.  When the obsession is aggressive, it is usually directed at a one person most valuable to the sufferer.
  
• Sexual obsessions include perverse sexual thoughts, images or impulses which may involve children, animals or incest.
  
• Obsessional slowness involves the obsession to have objects or events in a certain order or position, to do and undo certain actions in an exact way or to have things perfectly symmetrical, and doing all this slows one down.

Many OCD patients have a combination of symptoms, although one symptom type, such as washing, checking or obsessional slowness, may predominate.  And at different points in the course of the illness, patients report that different OCD symptoms are predominant.  For example, people may have had predominantly washing rituals as a child, and have checking rituals as an adult.