Obsessive-compulsive disorder is an anxiety disorder in which a person has an unreasonable thought, fear, or worry that he or she may try to manage by performing a ritual activity to reduce the anxiety. Frequently occurring disturbing thoughts or images are called obsessions, and the repeated rituals performed to try to prevent or dispel them are called compulsions. Problems arise as the behaviors interfere with daily life functioning, school or job performance and managing personal relationships. 

During the normal growth and developmental process of children and adolescents, rituals and obsessive thoughts normally occur with a purpose and focus based on age. Preschool children often use rituals and routines around mealtimes, bath and bedtime to help them stabilize their expectations and understanding of their world.

School-aged children normally develop group rituals as they learn to play games, team sports and recite rhymes. Older children and teens begin to collect objects and develop hobbies.

An individual with OCD has obsessive thoughts that are unwanted and related to fears (such as a fear of touching dirty objects) and uses compulsive rituals to control the fears (such as excessive hand washing).

When OCD is present, obsessive thoughts cause distress and compulsive rituals can become so frequent or intense that they interfere with activities of daily living (ADLs) and normal developmental activities.