This year's World Mental Health Day celebrated on October 10 has been different because of the COVID-19 pandemic.

The international awareness day has shed light on the alarming increase in mental disorders amid the pandemic that affects millions of people worldwide.

Mental health specialists said they saw an increase in the number of cases of obsessive-compulsive disorder (OCD) these days.  

Pure Obsessive-Compulsive Disorder: Obvious Signs for People with No Visible Compulsions

(Photo : Naomi August @naomi_august/ Unsplash)
Pure Obsessive-Compulsive Disorder: Obvious Signs for People with No Visible Compulsions

However, the Purely Obsessional OCD, also known as Pure OCD or Pure O, is a mental health condition that is often overlooked. Pure OCD can be hard to diagnose because people suffering from it have no visible compulsions. Their compulsions are often hidden. 

The presence of overt compulsions is normally required to improve the accuracy of OCD's diagnostics. According to the World Health Organization, OCD is among the top 20 causes of illness-related disability worldwide, involving persons between 15 and 44 years of age. 

For your reference, here are the things to know about Pure OCD and how is it different from the traditional OCD:

How to determine if you have OCD?

According to DSM-5, which is the primary diagnostic tool for experts, the presence of compulsions, obsessions, or both can determine if a person have OCD. Meaning, the presence of obsessive thoughts alone can be evidence for a diagnosis of OCD.


Pure OCD symptoms vary from person to person. But some common symptoms include obsessive thoughts that are sexual, violent, or religious. With the guide of California OCD and Anxiety Treatment Center, here are the examples of Pure OCD symptoms:

  • Persistent fears of unintentional harming themselves or others.
  • Constant fears of engaging in offensive sexual acts such as child molestations.
  • Unwanted thoughts of intentionally causing harm to themselves or others.
  • Having mind questions about the nature of themselves or reality.
  • Repeated thoughts of saying or doing something inappropriate by themselves.
  • Unwanted thoughts that they may consider being blasphemous or sacrilegious.

People with Pure OCD will engage in compulsive behaviors to relieve the distress brought on by these obsessive thoughts. Below are examples of such compulsive behaviors:

  1. Repeatedly seek the reassurance of not acting obsessive thoughts.
  2. Confessing to people about having unacceptable thoughts.
  3. Avoiding situations or places that may trigger your obsessive thoughts.
  4. Engage in superstitious behaviors to prevent bad things from happening.

What is the difference between Pure OCD and traditional OCD? 

Typically, people with OCD have obsessive thoughts that result in visible compulsions. However, for people with Pure OCD, these compulsions are hidden most of the time. Instead, these hidden compulsions often become mental rituals. Here are some examples from the Anxiety and Depression Association of America:

Gail Sartz, MD, an associate professor of psychiatry at the New York-Presbyterian Hospital, Weill-Cornell Medical College, said: "While it is true that they do not have visible behaviors they feel compelled to do in response to their obsessions, most people living with Pure O have mental compulsions."  

These mental compulsions are an individual's way of dealing with anxiety, which causes them to think. Sartz added that even if a person feels like not having to do them, they still feel the need to do them just like behavioral compulsions. 


Treatment for Pure OCD can be challenging because, unlike other OCD types, there are no obvious compulsive behaviors to treat this condition. According to Sartz, Pure OCD is initially more difficult to treat because it is harder to prevent mental activity than physical action.But he said a trained professional could determine a compulsion mental activity and how a person can avoid doing it. 

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