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Aetiology and pathogenesis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

A genetic predisposition is likely based on twin and genome-wide linkage studies.

  • twin studies which group OCD with obsessive personality show concordance rates as high as 87% in monozygotic twins and 47% in dizygotic twins

The following risk factors may be associated with development of OCD:

  • developmental factors
    • emotional, physical, and sexual abuse
    • neglect
    • social isolation
    • teasing
    • bullying
  • psychological factors
    • over-inflated sense of responsibility
    • magical thinking
    • an intolerance of uncertainty
    • a belief in the controllability of intrusive thoughts
  • stressors
    • pregnancy
    • postnatal period


  • in adults OCD symptoms can be a consequence of certain neurological conditions such as a brain tumour, Sydenham’s chorea, Huntington’s chorea, or frontotemporal dementia or as a complication of brain injury to the frontal lobe or basal skull
  • in children it is associated with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) in which they develop an abrupt onset of OCD symptoms or tics after infection with group A Streptococcus (1,2)


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