Initial Data Characterizing the Progression from Obsessions and Compulsions to Full-Blown Obsessive Compulsive Disorder

Most individuals who develop obsessive compulsive disorder (OCD) experience years of obsessions and/or compulsions preceding
onset of the full-blown disorder (Angst in Current insights in obsessive compulsive disorder, Wiley, Chirchester, New York,
Brisbane, 1994; Coles et al. in Behav Cogn Psychother 11:1–11, 2011; Pinto et al. in J Clin Psychiatry 67(5):703–711, 2006). However, little is known about experiences during this period and about factors that are involved in the generation of
interference or distress that signals the onset of diagnosable OCD. Therefore, the current study was designed to provide data
on the characteristics of the symptom phase of OCD and potential markers of the transition from symptoms to the full-blown
disorder. Individuals that eventually developed full-blown OCD retrospectively reported that generalized anxiety, perfectionism,
impaired work or school performance, social isolation, preoccupation with details and intolerance of uncertainty, frequently
emerged after their initial OC symptoms but before full-criteria for OCD were met. Increases in stress level, the desire for things to feel ‘just right’, and the amount of
attention paid to one’s thoughts were perceived as having played an important role in the transition to OCD. Additional data
and theory development regarding the progression from symptoms to OCD is warranted.