mother-infant relationship (e.g., aggressive ob sessions leading to avoidance of the infant),
have been reported in the peripartum period. 
Suicide Risk
Suicidal thoughts occur at some point in as many as about half of individuals with OCD.
Suicide attempts are also report ed in up to one-quarter of individuals with OCD; the pres-
ence of comorbid major depressiv e disorder increases the risk. 
Functional Consequences of 
Obsessive-Compu lsive Disorder
OCD is associated with reduced quality of life as  well as high levels of social and occupa-
tional impairment. Impairment occurs across many different domains of life and is asso-
ciated with symptom severity. Impairment can be caused by the time spent obsessing and
doing compulsions. Avoi dance of situations that can tr igger obsessions or compulsions
can also severely restrict functioning. In addition, specific sympto ms can create specific
obstacles. For example, obsessions about harm can make relationships with family and
friends feel hazardous; the result can be av oidance of these rela tionships. Obsessions
about symmetry can derail the timely completion of school or work projects because the
project never feels “just right,” potentially resulting in school failure or job loss. Health
consequences can also occur. For example, individuals with contamination concerns may
avoid doctors’ offices and hospit als (e.g., because of fears of exposure to germs) or develop
dermatological problems (e.g., skin lesion s due to excessive washing). Sometimes the
symptoms of the disorder inte rfere with its own treatment (e .g., when medications are con-
sidered contaminated). When th e disorder starts in childhood  or adolescence, individuals
may experience developmental difficulties. Fo r example, adolescents may avoid socializ-