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.

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Although some people do certain things over and over again, they do not necessarily perform these actions compulsively.

For example, bedtime routines, learning a new skill, and religious practices are not compulsions.

In other words, habits tend to bring efficiency to one's life, while compulsions tend to disrupt it.

In addition to the anxiety and fear that typically accompanies OCD, sufferers may spend hours performing such compulsions every day.

The observed groups included a "symmetry factor", a "forbidden thoughts factor", a "cleaning factor", and a "hoarding factor".

The "symmetry factor" correlated highly with obsessions related to ordering, counting, and symmetry, as well as repeating compulsions.OCD without overt compulsions could, by one estimate, characterize as many as 50 percent to 60 percent of OCD cases.Some people with OCD perform compulsive rituals because they inexplicably feel they have to, while others act compulsively so as to mitigate the anxiety that stems from particular obsessive thoughts.Furthermore, some subtypes have been associated with improvement in performance on certain tasks such as pattern recognition (washing subtype) and spatial working memory (obsessive thought subtype).Subgroups have also been distinguished by neuroimaging findings and treatment response.The "forbidden thoughts factor" correlated highly with intrusive and distressing thoughts of a violent, religious, or sexual nature.