Aggressive obsessions—intrusive thoughts of intentionally or unintentionally harming oneself or others—are a common feature of obsessive-compulsive disorder (OCD), according to a study in the Journal of Psychiatric Research.Why It’s Relevant
Aggressive obsessions are distressing for patients, commonly misdiagnosed by health care providers, and highly stigmatized. Increased awareness and education regarding the nature of aggressive obsessions may help clinicians identify these debilitating symptoms and provide appropriate treatment.
By the Numbers
- Study investigators analyzed 110 studies across more than 20 countries that reported the lifetime or current prevalence of obsessive-compulsive symptoms in adult patients with OCD.
- Lifetime and current (i.e., past-week) prevalence rates of aggressive obsessions were 70.3% and 52.6%, respectively.
- Aggressive obsessions were the primary and most distressing symptom for 28% of patients.
- Patients with early-onset OCD and/or suicidal ideation were more likely to report aggressive obsessions than patients with late-onset OCD and/or no suicidal ideation.
The Other Side
Because more than 75% of the sample consisted of outpatients, the findings are generalizable primarily to people who seek treatment. In addition, the researchers were unable to examine the prevalence of individual subtypes of aggressive obsessions (e.g., thoughts of intentional versus unintentional harm).
Takeaway Message
The researchers noted that the results underscore the importance of appropriate recognition and treatment of aggressive obsessions in OCD, given how commonly they are misidentified. “Increased knowledge, skills, and confidence in judicious application of such skills is recommended for health care providers regarding aggressive obsessions to help reduce shame and stigma associated with this condition, potentially encouraging those affected to seek treatment.”
Related Information
Source
Emily J. Fawcett, et. al. The prevalence and predictors of aggressive obsessions in obsessive-compulsive disorder: a meta-analytic review. Journal of Psychiatric Research. Published January 29, 2026. doi: doi.org/10.1016/j.jpsychires.2026.01.051
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