Furthermore, severe and frequent overvalued ideas are considered similar to idealized values, which are so rigidly held by, and so important to affected individuals, that they end up becoming a defining identity. In adolescent OCD patients, OVI is considered a severe symptom.Historically, OVI has been thought to be linked to poorer treatment outcome in patients with OCD, but it is currently considered a poor indicator of prognosis. The Overvalued Ideas Scale (OVIS) has been developed as a reliable quantitative method of measuring levels of OVI in patients with OCD, and research has suggested that overvalued ideas are more stable for those with more extreme OVIS scores. Cognitive performance
Though OCD was once believed to be associated with above-average intelligence, this does not appear to necessarily be the case. A 2013 review reported that people with OCD may sometimes have mild but wide-ranging cognitive deficits, most significantly those affecting spatial memory and to a lesser extent with verbal memory, fluency, executive function, and processing speed, while auditory attention was not significantly affected. People with OCD show impairment in formulating an organizational strategy for coding information, set-shifting, and motor and cognitive inhibition.Specific subtypes of symptom dimensions in OCD have been associated with specific cognitive deficits. For example, the results of one meta-analysis comparing washing and checking symptoms reported that washers outperformed checkers on eight out of ten cognitive tests. The symptom dimension of contamination and cleaning may be associated with higher scores on tests of inhibition and verbal memory. Children
Approximately 1–2% of children are affected by OCD.
Surgery may be used as a final resort in the most severe or treatment-resistant cases, though most procedures are considered experimental due to the limited literature on their side effects. Without treatment, OCD often lasts decades.Obsessive–compulsive disorder affects about 2.3% of people at some point in their lives, while rates during any given year are about 1.2%. It is unusual for symptoms to begin after age 35, and around 50% of patients experience detrimental effects to daily life before age 20. Males and females are affected equally, and OCD occurs worldwide. The phrase obsessive–compulsive is sometimes used in an informal manner unrelated to OCD to describe someone as excessively meticulous, perfectionistic, absorbed, or otherwise fixated. Signs and symptoms
OCD can present with a wide variety of symptoms. Certain groups of symptoms usually occur together; these groups are sometimes viewed as dimensions, or clusters, which may reflect an underlying process. The standard assessment tool for OCD, the Yale–Brown Obsessive Compulsive Scale (Y-BOCS), has 13 predefined categories of symptoms. These symptoms fit into three to five groupings. A meta-analytic review of symptom structures found a four-factor grouping structure to be most reliable: a symmetry factor, a forbidden thoughts factor, a cleaning factor, and a hoarding factor. The symmetry factor correlates highly with obsessions related to ordering, counting, and symmetry, as well as repeating compulsions. The forbidden thoughts factor correlates highly with intrusive and distressing thoughts of a violent, religious, or sexual nature. The cleaning factor correlates highly with obsessions about contamination and compulsions related to cleaning.