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Description: chronic anxiety-provoking thoughts and repetitive rituals that the person cannot control.

Obsessive-compulsive disorder (OCD), which affects an estimated one in fifty people, frequently arises during the teen years. It can be the most disabling of the anxiety disorders. In OCD, the mind torments youngsters by replaying the same distressing or pointless thoughts, called obsessions. Imaging studies have revealed that people with obsessive-compulsive disorder have a brain chemical imbalance.

No matter how hard the patient tries to tune out the intrusive, unwelcome thought, it repeats itself dozens or hundreds of times a day. The classic obsession is a preoccupation with cleanliness. My hands must be dirty. To banish the thought—and with the hope of preventing it from recurring—he feels driven to carry out a routine, or compulsion; in this case, washing his hands over and over. The ritual, which can be painstakingly elaborate, brings temporary relief but not pleasure. If it isn’t performed exactly or a certain number of times, some people with OCD can become extremely anxious and upset. Most of them realize that these thoughts and behaviors are irrational and alienating to others. They will go to great lengths to hide their symptoms, and that in itself becomes an enormous strain.

These teenagers are often haunted by multiple obsessions and compulsions, the most common being the fear of germs and subsequent cleaning rituals. Other examples of obsession/compulsion tandems include the nagging thought that you’ve left the lights on or forgotten to lock a door, coupled with the need to check it again and again. Such senseless activities typically consume at least an hour of an OCD patient’s day and may eventually interfere with his education, career, and social life. For that reason, obsessive compulsive disorder is one of the conditions covered under the Americans with Disabilities Act (ADA), the landmark federal law that prohibits discrimination against people with physical or mental impairments.

Signs of Obsessive-Compulsive Disorder


  • fear of contamination
  • thoughts of harming oneself or committing violence against others


  • excessive hand washing
  • checking behavior (locks, windows, doors, the stove, the iron)
  • the need to constantly touch or rearrange objects
  • excessive house cleaning
  • hoarding
  • incessant counting, praying, mentally repeating words or phrases
  • making endless series of lists


Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.