Total severity scores are usually assumed to indicate the following levels of OCD: subclinical (0–7), mild (8–15), moderate (16–23), severe (24–31) and extremely severe (32–40).
Harm OCD. Harm OCD causes people to be deeply disturbed by the violent thoughts that just about everyone has experienced. While most people are able to shrug off these thoughts, those with harm OCD can become completely overwhelmed by them.
Both scales rate OCD symptoms on a scale with a range from 0 (no symptoms) to 40 (severe OCD), with a score less than 8 considered as subclinical symptomatology, over 16 as clinically significant symptoms, and over 24 as moderate to severe OCD.
At its most severe, however, OCD can impact someone's ability to work, go to school, run errands, or even care for themselves. People with severe OCD have obsessions with cleanliness and germs — washing their hands, taking showers, or cleaning their homes for hours a day.
OCD Prevalence by Severity
More than 80% of people with OCD report moderate to severe impairment overall. In fact, only 15% of those with OCD said that their symptoms were mild, making this one of the most debilitating mental health conditions.
The OCD cycle consists of 4 basic parts: obsessions, anxiety, compulsions, and temporary relief. It's considered a “vicious” cycle because once you get pulled into it, it gains momentum and strength, making it even more difficult for you to get out.
The type of abnormal activity, though, is quite different: those with OCD exhibit significantly higher levels of activity in this system, while those with ADHD exhibit significantly lower levels of activity in it.
An estimated 1.2% of U.S. adults had OCD in the past year.
Obsession symptoms
OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual.
Diagnosis and Tests
The criteria include: Having obsessions, compulsions or both. The obsessions or compulsions take up a lot of time (more than an hour per day). The obsessions or compulsions cause distress or affect your participation in social activities, work responsibilities or other life events.
These would include intrusive unpleasant thoughts, unceasing doubt, guilt fears of being insane, and crushing anxiety. While all forms of OCD can be painful, paralyzing, repulsive, and debilitating one of the nastier and more startling is the type known as morbid obsessions.
It's unlikely that OCD can actually cause schizophrenia to develop. But while OCD doesn't necessarily cause schizophrenia, it can come with higher chances of experiencing it than people without OCD.
OCD is chronic
You can get it under control and become recovered but, at the present time, there is no cure. It is a potential that will always be there in the background, even if it is no longer affecting your life.
Early-Onset and Late-Onset OCD
While OCD can develop at any age, the age groups OCD affects the most at onset are childhood and adolescence. OCD is considered early-onset when symptoms start showing at about age ten, with late-onset symptoms emerging at approximately age 23.
OCD and ASD frequently occur together. Research from 2015 found that 17% of autistic people also had OCD. The rate of OCD in the general population is 1.6%. Further research from 2020 estimated that 17%–37% of young autistic people also had OCD symptoms.
And an even larger proportion of people with OCD may also have undiagnosed autism, according to one 2017 study. Part of that overlap may reflect misdiagnoses: OCD rituals can resemble the repetitive behaviors common in autism, and vice versa.
OCPD is a personality disorder. It looks and feels different than OCD. People with OCPD are strongly focused on—even obsessed with—a goal of perfection for themselves and others.
OCD is known to encourage traits of perfectionism and meticulousness. Many people with OCD have enhanced organizational skills and a heightened ability to foresee sequences of events necessary for categorization and planning.
Can OCD lead to brain damage? OCD fundamentally changes the brain, showing a significant reduction in grey matter density in some regions. In severe cases, this can permanently change how the brain works for patients with OCD. However, most people can lead normal and happy lives with therapy and medication.
OCD can start at any time from preschool to adulthood. Although OCD does occur at earlier ages, there are generally two age ranges when OCD first appears: Between ages 10 and 12 and between the late teens and early adulthood. It typically starts between 18 and 25 but can begin anytime.
Obsessive-compulsive symptoms generally wax and wane over time. Because of this, many individuals diagnosed with OCD may suspect that their OCD comes and goes or even goes away—only to return. However, as mentioned above, obsessive-compulsive traits never truly go away. Instead, they require ongoing management.
These obsessions and compulsions can range in severity, but what causes OCD to get worse over time is not properly managing the condition earlier on. Stress, trauma, avoidance, or even something as seemingly innocuous as a change in routine can all contribute to the worsening of OCD.