More than a quarter of US adults have had obsessions or compulsions; 2.3% have had OCD
In the National Comorbidity Survey Replication, over one in four adults reported obsessions or compulsions at some point. Only 2.3% ever met full criteria for OCD and 1.2% in the past year. Having the thoughts is not the diagnosis.
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: A survey threshold, not a clinical assessment: the 2.3% is DSM-IV criteria applied by interview. The authors argue the subthreshold quarter carries real burden, so the gap between 25% and 2.3% is not a reassurance and should not be read as one.
The population answer to "is this OCD": the thoughts are common, the disorder is not.
Significant findings
Ruscio, Stein, Chiu and Kessler used the National Comorbidity Survey Replication, a nationally representative survey of US adults, and assessed a subsample of 2,073 respondents for lifetime DSM-IV obsessive compulsive disorder.
"More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives." The chance of having OCD rose steeply with the number of obsessions and compulsions a person reported. But "only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD."
Where OCD was present, it rarely travelled alone: "substantial comorbidity, not only with anxiety and mood disorders but also with impulse-control and substance use disorders." Severity, measured with an adapted Yale-Brown scale, went with "poor insight, high comorbidity, high role impairment, and high probability of seeking treatment."
The other direction
The authors do not read the gap between 25% and 2.3% as reassurance. They write that "the high prevalence of subthreshold OCD symptoms" may explain why earlier surveys disagreed, and "suggests that the public health burden of OCD may be greater than its low prevalence implies." Symptoms that fall short of the full diagnosis can still cost people a great deal; the survey measured a threshold, not the experience under it.
What this does not show
A survey cannot diagnose anyone, and neither can a library row. The difference between an intrusive thought and OCD is not the thought; it is how much distress it causes, how much time it takes and how much it interferes. Those are questions for an assessment, not a checklist.
Worth asking
How much of my day is going to these thoughts and the things I do about them?
Source
The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication — Ruscio AM, Stein DJ, Chiu WT, Kessler RC (2010)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1038/mp.2008.94
DOI: 10.1038/mp.2008.94
How this was scored
- Study design
- Cross-sectional study / survey
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- 2,073
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "early signal". Suggestive but preliminary. Not settled. It scores 45 out of 100 on our published rubric. One caveat travels with that badge: A survey threshold, not a clinical assessment: the 2.3% is DSM-IV criteria applied by interview. The authors argue the subthreshold quarter carries real burden, so the gap between 25% and 2.3% is not a reassurance and should not be read as one. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication — Ruscio AM, Stein DJ, Chiu WT, Kessler RC (2010). Published in: Reputable peer-reviewed journal. DOI: 10.1038/mp.2008.94. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cross-sectional study / survey. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.