In a community health survey, which population (age group) is most likely to have recently developed obsessive‑compulsive disorder symptoms?

Age Group Most Likely to Have Recently Developed OCD Symptoms

In a community health survey, individuals aged 18-29 years are most likely to have recently developed OCD symptoms, representing the peak incidence window for new-onset obsessive-compulsive disorder. 1

Peak Risk Age Group

The strongest sociodemographic predictor of lifetime OCD is age, with the highest odds of onset occurring in the 18-29 year age bracket 2, 1. This represents the period of greatest risk for developing OCD in the general population 1.

Sex-Specific Onset Patterns Within This Age Group

While the 18-29 age range represents peak risk overall, important sex differences exist in onset timing:

Males

• Approximately 25% of males experience OCD onset before age 10, representing an earlier peak for a substantial minority 2, 1
• Males show a bimodal distribution with one peak in preadolescent childhood and another in young adulthood 3

Females

• Females typically experience onset during adolescence, which extends into the 18-29 peak risk window 2, 1
• A subset of women may develop OCD during the peripartum or postpartum period 2, 1
• Females are more common than males in community epidemiological studies 2, 4

Clinical Context for Community Surveys

When screening a general community population, you should expect the 18-29 age group to yield the highest number of recently developed cases. 1 This age bracket captures both late adolescent onset (common in females) and young adult onset (common in both sexes) 2.

Important Considerations for Adolescents

While not the absolute peak, adolescents warrant special attention because:

• OCS are common in community youth (38.2% report some symptoms), though only 3% meet threshold OCD criteria 5
• Obsessive-compulsive symptoms increase with age during childhood and adolescence 6
• The majority of OCD cases emerge by early adulthood, making late adolescence a critical transition period 6

Clinical Pitfalls to Avoid in Community Screening

• Do not dismiss symptoms in the 18-29 age group as "just stress" – this is the highest-risk period for true OCD onset 1
• Avoid misdiagnosing OCD with absent insight as a psychotic disorder, especially in younger patients within this age range 1, 4
• Distinguish OCD from normal developmental rituals by confirming symptoms are time-consuming (exceeding 1 hour per day) and cause functional impairment 1, 7
• Remember that while early childhood onset (before age 10) occurs in about 25% of males, the 18-29 bracket still represents the single largest risk window across the entire population 2, 1