Which statement about the onset of obsessive-compulsive disorder is correct?

• A Females consistently have an earlier onset than males
• B Onset is evenly distributed across the lifespan
• C Mean age of onset is earlier in males than in females ✓
• D Onset almost never occurs before the age of 25 years

Explanation

OCD shows a bimodal onset distribution, and males have the earlier peak, typically in childhood or adolescence, whereas females more often develop the disorder in their early twenties. Childhood-onset OCD is more common in boys and is associated with tic-related OCD. Onset after the age of 40 is uncommon but well described, so late-onset cases do occur.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

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