Risk factors include a history of child abuse or other stress inducing event.Some cases have been documented to occur following infections.

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Within and among individuals, the initial obsessions, or intrusive thoughts, vary in their clarity and vividness.

A relatively vague obsession could involve a general sense of disarray or tension accompanied by a belief that life cannot proceed as normal while the imbalance remains.

A more intense obsession could be a preoccupation with the thought or image of someone close to them dying Other obsessions concern the possibility that someone or something other than oneself—such as God, the Devil, or disease—will harm either the person with OCD or the people or things that the person cares about.

Other individuals with OCD may experience the sensation of invisible protrusions emanating from their bodies, or have the feeling that inanimate objects are ensouled.

Some people with OCD experience sexual obsessions that may involve intrusive thoughts or images of "kissing, touching, fondling, oral sex, anal sex, intercourse, incest and rape" with "strangers, acquaintances, parents, children, family members, friends, coworkers, animals and religious figures", and can include "heterosexual or homosexual content" with persons of any age.

As with other intrusive, unpleasant thoughts or images, some disquieting sexual thoughts at times are normal, but people with OCD may attach extraordinary significance to the thoughts.For example, obsessive fears about sexual orientation can appear to the person with OCD, and even to those around them, as a crisis of sexual identity.Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly (called "rituals"), or have certain thoughts repeatedly.People are unable to control either the thoughts or the activities for more than a short period of time.Common activities include hand washing, counting of things, and checking to see if a door is locked. These activities occur to such a degree that the person's daily life is negatively affected.There appear to be some genetic components with both identical twins more often affected than both non-identical twins.