Who Can Get OCD? A Look at OCD By The Numbers

Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects millions of people worldwide. Characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions), it can significantly impair daily functioning. While there is no clear profile of who may be at risk for developing OCD, it is a heterogeneous condition that arises from a complex mix of variables that are thought to play a role. In this article, we’ll explore these factors with a detailed look at the statistics behind OCD.

What is OCD?

OCD is a mental health disorder marked by a cycle of obsessions and compulsions. Obsessions are persistent, intrusive thoughts, images, or urges that cause significant anxiety or distress. Common examples include fear of contamination, aggressive or sexual thoughts, and concerns about symmetry or orderliness. To alleviate this distress, individuals often engage in compulsive behaviors, such as excessive hand-washing, checking locks, repeating phrases, or mentally reviewing situations to seek reassurance.

While it’s not uncommon to occasionally experience intrusive thoughts or engage in repetitive behaviors, people living with OCD cannot control these actions, leading to significant emotional distress and impaired functioning in their daily lives. OCD can be severe, chronic, and disabling without proper treatment, which typically involves a combination of cognitive-behavioral therapy (CBT), particularly Exposure and Response Prevention (ERP), and medication, like selective serotonin reuptake inhibitors (SSRIs).

Onset of OCD

OCD typically begins in childhood, adolescence, or early adulthood. The age of onset can vary significantly between individuals, but two distinct peaks have been identified:

• Early-onset OCD: This type typically emerges between ages 8 and 12, with an average age of onset of 11 years old. 
• Late-onset OCD: Usually presents in individuals between ages 18 and 25, with an average age of onset of 23 years old.

The median age of onset for OCD is 19 years old with about 25% of cases presenting by age 14 and about 75% of cases emerging by age 24. OCD most commonly emerges between 18 and 29 years old. Although not common, OCD can develop later in life. 

Early onset of OCD is more common in males, while late onset is more often observed in females. 

Prevalence of OCD

Obsessive-Compulsive Disorder affects approximately 1% to 3% of the global population, making it one of the most common mental health disorders. This means that about 80 to 250 million people worldwide are estimated to have OCD. 

Lifetime prevalence of OCD has been estimated at about 2.3% in adults, meaning that about 1 in 40 adults will experience OCD at some point in their lives.

In the United States, OCD affects about 1.2% or 2.2 to 2.8 million adults each year according to the National Institute of Mental Health (NIMH). For children and teens, the prevalence is about 0.25% to 4% or about 500,000 children in the U.S. living with OCD.

OCD by Gender

While OCD affects both men and women, there are notable gender differences in prevalence, onset, and symptom presentation:

Males 

• OCD tends to have an earlier onset in males, with symptoms often developing in childhood or early adolescence. 
• Boys are more likely to be diagnosed with OCD before the age of 10.
• Statistics suggest that about 0.5% of men will experience OCD at some point.
• Men are more likely to present with symmetry, ordering, and checking compulsions.

Females

• Women tend to develop OCD later, often during adolescence or early adulthood.
• Women are about 1.6 times more likely than men to experience OCD at some point in their lives. 
• Women are more likely to present with contamination-related obsessions and compulsions. 

OCD by Age 

OCD can affect individuals of all ages, but certain age groups are more vulnerable:

• Children and Adolescents: OCD is one of the most common psychiatric disorders found in childhood and adolescence. While the onset is generally in late childhood/early teen years, OCD can be diagnosed in children as young as 5 or 6. OCD in children often co-occurs with other disorders such as anxiety, depression, and tic disorders.
• Adults: While many adults with OCD are diagnosed in early adulthood (mean age is about 19), they often report having experienced symptoms during childhood, suggesting that the disorder may go undiagnosed for years. Adults tend to have more insight into their symptoms and are more likely to seek treatment compared to children.
• Older Adults: OCD is less common in older adults, but when it does occur, it often presents alongside other psychiatric or cognitive issues, such as depression or dementia. For some cases, there may be no clear explanation for the onset.  

OCD and Comorbidities 

OCD rarely exists in isolation, often co-occuring with other mental health disorders, which can complicate diagnosis and treatment, as well as impact overall functioning and quality of life. 

The most common comorbid conditions include:

• Anxiety Disorders: Over 50% of individuals with OCD may also have an anxiety disorder, such as generalized anxiety disorder (GAD), social anxiety disorder, or panic disorder.
• Depression: It’s estimated that about 60% of people with OCD will also be diagnosed with a depressive disorder. Depression may emerge as a result of the debilitating effects of OCD on daily functioning.
• Tic Disorders: Children and adolescents with OCD, particularly males, are more likely to have a comorbid tic disorder, such as Tourette syndrome. Research has shown that about 30% of children with early-onset OCD will also have a tic disorder.
• Obsessive Compulsive-Related Disorders (OCRDs): OCRDs include trichotillomania, excoriation disorder (commonly known as skin picking), body dysmorphic disorder (BDD), and hoarding. Studies have shown that around 50% of people with OCD may also have a co-occurring OCRD.  

OCD and Culture

OCD affects individuals across all ethnic and cultural backgrounds with most studies showing little difference in prevalence. What studies have shown is that social and cultural factors can influence the types of obsessions and compulsions experienced by individuals with OCD. For example, religious and moral obsessions may be more common in cultures with strong religious beliefs. Additionally, stigma and fears associated with mental health disorders as well as socioeconomic factors can vary across groups, potentially affecting the likelihood of seeking treatment and receiving a diagnosis.

OCD and Treatment

Treatment and recovery are possible with OCD. However, it is important to stress the importance of timely diagnosis. It has been widely reported that, like many other mental health disorders, people with OCD often go undiagnosed for many years before receiving a diagnosis and beginning treatment. 

For many years, it was thought that OCD was not treatable, but today’s therapeutic approaches offer relief. The most effective treatment is currently a combination of medication and psychotherapy. 

Exposure and Response Prevention (ERP), a specialized type of Cognitive Behavioral Therapy specifically developed for treating OCD, is considered the gold standard for OCD treatment, with symptom improvements reported as high as 75%. Studies have found that about 60% of people experience significant symptom reduction and about 25% of people achieve complete remission in symptoms. A recent study of ERP for OCD provided via teletherapy yielded similar results. Utilizing teletherapy may help to improve accessibility to care as well. 

Of course, not every person benefits from every approach. If you find that ERP is not helpful in symptom remission, treatment alternatives to ERP to consider may be:

• Cognitive Behavioral Therapy
• Acceptance and Commitment Therapy

While they may seem similar, ERP, CBT, and ACT are distinct therapeutic approaches. Which approach is right for you will depend on your unique treatment needs. A conversation with your mental health provider can help you to find the right option for you.

Conclusion

OCD is a complex and often debilitating mental health disorder that affects individuals across all age groups, genders, and ethnicities. Understanding the onset, prevalence, and demographic differences in OCD can help improve early detection, diagnosis, and access to treatment. 

References

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