OCD is characterized by the presence of obsessions or compulsions that are time consuming (at least an hour daily), cause subjective distress or interfere with the family life. Obsessions are intrusive, unwanted ideas, images, fears, thoughts or worries that are experienced as uncomfortable, unpleasant, distressing or anxiety provoking; while compulsions are repetitive behaviours, or mental acts performed to ignore, reduce or eliminate the anxiety or distress caused by the obsessive thoughts. There are four major symptom patterns of OCD. These include; contamination, pathological doubts, symmetry and intrusive thoughts. In contamination, there is persistent thoughts of dirt on them which results in constant hand washing that can interfere with daily functioning. Those with pathological doubts, the repeatedly perform the same task over and over again, thinking they have not done it. Example of such is constant checking of locks despite closing the door initially. In symmetry, they keep adjusting the position of things to ensure its well placed and the constant intrusive thoughts to check becomes distressing. The obsessive-compulsive symptoms vary considerably not only from patient to patient but also in the same patient over time.

The clinical findings in people with OCD usually relates to the type of OCD, they are mostly anxious and/or depressed. Those with contamination type can come with dry or cracked hands due to excessive hand washing.

They include; anxiety disorder, phobias, depression, excoriation (skin picking) disorder, trichotillomania, body dysmorphic disorder and hypochondriasis. About 60% to 80% of affected children and adolescents have one or more comorbid psychiatric disorders such as tic disorders, attention deficit hyperactivity disorder (ADHD), other anxiety disorders, mood and eating disorders, etc.

There are no specific investigations for OCD, diagnosis is clinical based on the presenting symptoms and mental state examination.

 Selective serotonin reuptake inhibitors (SSRI) are usually the drug of choice. Clomipramine can also be used. In severe cases, antipsychotics such as haloperidol can be used. Psychological treatment includes; cognitive behavioral therapy (CBT), exposure and response prevention, family therapy, and psychotherapy. Other treatment modalities are cingulotomy, and capsulotomy.

Follow-up depends on the severity of the symptoms and the modality of treatment used. 

OCD is a complex mental health disorder which most people might consider as a simple issue. With proper diagnosis and treatment, the quality of life improves significantly.