Wondering if your repetitive thoughts or behaviors might be OCD? While everyone has intrusive thoughts or habits sometimes, obsessive-compulsive disorder involves distressing patterns that significantly interfere with daily life. This evidence-based screening tool can help you understand your symptoms and whether professional evaluation might be helpful.
Key Takeaways
OCD is more than perfectionism: True OCD involves intrusive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that cause significant distress and take up substantial time.
OCD affects about 1-2% of people: Despite being less common than anxiety disorders, OCD is a serious condition that requires specialized treatment approaches.
Specific treatment works: Exposure and Response Prevention (ERP) therapy, a specialized form of CBT, is highly effective for treating OCD when delivered by trained professionals.
What Is OCD?
OCD involves a cycle of obsessions and compulsions that causes significant distress and interferes with daily functioning.
What Are Obsessions?
Obsessions are intrusive, unwanted thoughts, images, or urges that repeatedly enter your mind and cause significant anxiety or distress. They're not simply excessive worries about real-life problems.
Common obsession themes include:
Fear of contamination (germs, dirt, illness)
Need for symmetry or exactness
Unwanted forbidden thoughts (aggressive, sexual, religious)
Fear of harming yourself or others
Excessive doubt or need for reassurance
What Are Compulsions?
Compulsions are repetitive behaviors or mental acts you feel driven to perform in response to an obsession. These behaviors are aimed at reducing anxiety or preventing a feared outcome, even though they're excessive or not realistically connected to what they're meant to prevent.
Common compulsions include:
Excessive cleaning or handwashing
Checking (locks, appliances, etc.)
Counting or repeating actions
Ordering or arranging items
Seeking reassurance from others
Mental rituals (praying, counting, repeating phrases)
The OCD Self-Assessment
This self-assessment uses items from the Obsessive-Compulsive Inventory–Revised (OCI-R), a validated screening tool. It can help you recognize patterns consistent with OCD, but it does not diagnose OCD — only a licensed mental health professional can do that.
For each question, consider how much the symptom has bothered you over the past month:
0 = Not at all
1 = A little
2 = Moderately
3 = A lot
4 = Extremely
Questions
Obsessions
I have unwanted thoughts, images, or impulses that repeatedly enter my mind
These thoughts are distressing or upsetting to me
I find myself worrying excessively about mistakes, harm, or safety
I have repeated doubts about things I’ve done
I need things to be in a particular order or symmetrical
Compulsions
6. I wash or clean myself or objects excessively
7. I check things repeatedly (locks, appliances, switches)
8. I repeat routine actions multiple times
9. I count things or perform actions a specific number of times
10. I arrange or order items until they feel “just right”
11. I mentally repeat phrases, prayers, or actions
12. I seek reassurance from others repeatedly
Additional Symptoms / Interference
13. These behaviors or thoughts take up significant time each day
14. These behaviors or thoughts interfere with my work, school, or daily life
15. I experience distress when I cannot perform rituals or prevent feared outcomes
16. I avoid situations or activities because of obsessions or compulsions
17. My OCD symptoms cause problems in my relationships or social life
18. My OCD symptoms cause me distress or impairment in general
Scoring (OCI-R)
Add your responses for all 18 questions (0–4 per item).
Total score ranges from 0 to 72.
Total Score | Symptom Severity |
|---|---|
0–12 | Minimal / Low likelihood of OCD |
13–20 | Mild symptoms — monitor and consider professional evaluation if persistent |
21–26 | Moderate symptoms — professional evaluation recommended |
27+ | Severe symptoms — professional evaluation strongly recommended |
Important: Only a trained mental health professional can diagnose OCD. This tool is for self-reflection and educational purposes only.
What Your Score Means
Minimal / Low Likelihood (0–12)
Your responses suggest you are not currently experiencing significant OCD symptoms. Everyone has occasional intrusive thoughts or habits, and your experiences appear within a normal range.
If you are concerned about specific thoughts or behaviors, discussing them with a healthcare provider can provide clarity and support.
Mild Symptoms (13–20)
Your responses indicate some OCD-like symptoms. These may cause occasional distress or take some time, but typically do not significantly interfere with daily functioning.
Consider tracking when these thoughts or behaviors occur and whether they increase in frequency or intensity. If they begin interfering with work, school, or relationships, a professional consultation is recommended.
Moderate Symptoms (21–26)
Your responses suggest moderate OCD symptoms that likely affect daily life. Symptoms at this level often interfere with work, relationships, or personal wellbeing.
Professional evaluation is recommended. A mental health provider can perform a comprehensive assessment and discuss treatment options such as Exposure and Response Prevention (ERP) therapy or other evidence-based approaches.
Severe Symptoms (27+)
Your responses indicate severe OCD symptoms that are significantly impacting your quality of life. These symptoms may consume several hours a day and interfere with work, relationships, or self-care.
Professional treatment is strongly recommended. Research shows that specialized treatment, particularly ERP therapy combined with medication when appropriate, is highly effective even for severe OCD.
Scoring gives a general sense of symptom severity; it does not replace a clinical evaluation.
How Common Is OCD?
OCD affects approximately 1-2% of the population, according to the National Institute of Mental Health. It typically begins in childhood, adolescence, or early adulthood, though it can start at any age.
OCD affects people of all ages, races, and backgrounds equally. However, symptoms often first appear between ages 8-12 or in late teens to early twenties. About one-third of affected adults first experienced symptoms in childhood.
What Causes OCD?
Research suggests OCD results from a combination of biological, genetic, and environmental factors.
Brain Chemistry and Structure
Studies using brain imaging have found differences in how certain brain regions function in people with OCD. Research published in Biological Psychiatry shows that the orbitofrontal cortex, anterior cingulate cortex, and striatum—areas involved in planning, decision-making, and regulation of behavior—show different activity patterns in people with OCD.
Neurotransmitters, particularly serotonin, play a role in OCD. This is why medications that affect serotonin levels can help reduce symptoms.
Genetic Factors
OCD tends to run in families, suggesting genetic components. If you have a first-degree relative (parent, sibling, or child) with OCD, you have a higher risk of developing the disorder yourself.
Environmental Triggers
While biology creates vulnerability, environmental factors can trigger OCD onset or worsen symptoms:
Stressful life events
Trauma or abuse
Significant life transitions
Infections (in rare cases, pediatric autoimmune neuropsychiatric disorders)
Treatment Options for OCD
OCD requires specialized treatment approaches that differ from general anxiety treatment. The good news is that effective treatments exist.
Exposure and Response Prevention (ERP)
ERP is the gold standard therapy for OCD. Research shows that people with OCD who complete ERP treatment experience significant symptom reduction.
ERP involves:
Exposure: Gradually confronting feared situations or triggering obsessive thoughts in a controlled way.
Response Prevention: Resisting the urge to perform compulsive behaviors when anxiety arises.
For example, someone with contamination fears might touch a doorknob (exposure) without washing their hands afterward (response prevention). Over time, this breaks the cycle of obsessions and compulsions.
Medication
Selective serotonin reuptake inhibitors (SSRIs) are often prescribed for OCD, typically at higher doses than used for depression. Common medications include:
Fluoxetine (Prozac)
Sertraline (Zoloft)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
The tricyclic antidepressant clomipramine is also effective for OCD but has more side effects than SSRIs.
Medication often works best when combined with ERP therapy. Studies show that combined treatment produces better outcomes than either approach alone.
Cognitive Behavioral Therapy (CBT)
While ERP is a specialized form of CBT, broader CBT approaches can help address thought patterns and beliefs that maintain OCD symptoms.
When to Seek Professional Help
You should consider a professional evaluation if:
Obsessive thoughts or compulsive behaviors take up more than 1 hour per day
These symptoms interfere with work, school, or relationships
You feel distressed or impaired by these symptoms
You're avoiding situations because of obsessions or compulsions
Family members have expressed concern about your behaviors
How Online Psychiatry Can Help with OCD
Virtual psychiatric care through platforms like Blossom Health can be particularly helpful for OCD treatment:
Accessibility: Connect with providers who specialize in OCD treatment, which can be harder to find in some geographic areas.
Convenience: Attend therapy sessions from home, which is especially helpful when OCD involves contamination fears or travel-related compulsions.
Consistency: Maintain regular treatment even when circumstances change.
Medication management: Psychiatric providers can prescribe and monitor OCD medications virtually.
The Bottom Line
If your screening results suggest OCD, remember that you're not alone and effective treatment is available. OCD is a medical condition involving specific brain patterns—it's not a character flaw or weakness.
The most important step is seeking evaluation from a mental health professional who specializes in OCD treatment. With proper care, most people with OCD can significantly reduce symptoms and reclaim their lives from intrusive thoughts and compulsions.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you're experiencing a mental health emergency, call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding medications or mental health treatment. Never disregard professional medical advice or delay seeking it because of something you have read in this article. If you are experiencing a mental health crisis, call 988 (Suicide and Crisis Lifeline) or seek immediate emergency care.
