More than one-fifth of young people in Singapore have probable obsessive–compulsive disorder (OCD), according to local research.
In a cohort of 15–35-year-olds, the point prevalence of probable OCD was 22.1 percent and differed across subgroups defined by age, ethnicity, education level, and employment status. [Compr Psychiatry 2026:149:152731]
The odds of probable OCD were between 66 percent and 78 percent higher among individuals age 15–19 years (odds ratio [OR], 1.66, 95 percent confidence interval [CI], 1.05–2.64; p=0.032) and 20–24 years (OR, 1.78, 95 percent CI, 1.21–2.62; p=0.003) relative to those age 30–35 years.
Compared with Chinese youths, Malays were more likely to have probable OCD (OR, 1.90, 95 percent CI, 1.46–2.47; p<0.001), as were Indians (OR, 1.43, 95 percent CI, 1.09–1.88; p=0.009) and youths of other ethnicities (OR, 1.62, 95 percent CI, 1.04–2.51; p=0.033).
Youths holding lower levels of educational attainment had around twofold increased odds of probable OCD compared with those holding qualifications at undergraduate and post-graduate levels (primary: OR, 2.15, 95 percent CI, 1.23–3.76; p=0.007; secondary: OR, 2.14, 95 percent CI, 1.37–3.34; p=0.001; vocational/technical: OR, 1.92, 95 percent CI, 1.25–2.96; p=0.003).
For youths who were economically inactive, the odds of probable OCD were 27-percent lower than their employed peers (OR, 0.73, 95 percent CI, 0.56–0.96; p=0.025).
“The observed prevalence of probable OCD is markedly higher than the 6.7 percent OCD prevalence in the last nationwide Singapore Mental Health Study (SMHS),” the authors noted.
“However, a key point to consider would be that our study investigated ‘probable’ OCD, which inherently yields higher prevalence rates as it includes a broader at-risk population of youth experiencing OCD-related distress that may not meet formal diagnostic criteria,” they pointed out.
In the study, the authors used the revised Obsessive Compulsive Inventory (OCI-R) tool to evaluate the presence and severity of symptoms in individuals potentially struggling with OCD. On the other hand, structured diagnostic interviews such as the Composite International Diagnostic Interview (CIDI) were conducted in SMHS.
“Our prevalence of probable OCD alongside existing literature does highlight the highly pervasive nature of the disorder that often goes unnoticed among youth in community settings,” the authors said.
Increased psychological burden
Another noteworthy finding was the association of probable OCD with increased psychological burden.
A substantial percentage of youths with probable OCD experienced severe to extremely severe symptoms of anxiety (62.9 percent; OR, 3.55; p<0.001), depression (38.6 percent; OR, 1.58; p=0.012), and stress (34.2 percent; OR, 1.62; p=0.010).
Additionally, higher functional impairment was associated with higher likelihood of meeting criteria for probable OCD (OR, 1.10; p<0.001). This association, according to the authors, underscores the “impact of persistent obsessions and compulsions on daily functioning, including difficulties in completing routine tasks, maintaining social relationships and fulfilling occupational roles.”
Meanwhile, results for the association between probable OCD and alcohol dependence were mixed. Only when OCD was evaluated as a continuous spectrum of symptom severity rather than a categorical diagnosis did a significant association with alcohol dependence emerge.
“Alcohol dependence may be more closely related to increasing symptom burden than to threshold-defined probable OCD,” the authors noted.
Comprehensive screening needed
Taken together, the findings highlight the need for comprehensive screening and tailored interventions to support at-risk youth, according to the authors.
“Going forward, policymakers should consider funding mental health screening at vital youth touch points such as school and work. This way, symptomatic youth can receive prompt referral to appropriate mental health resources, where early diagnostic support and psychological services are offered early,” they said.
The study included 2,600 youths age 15–35 years recruited via convenience sampling. Of these, 34.6 percent were age 30–35 years, 50.2 percent were female, and 71.5 percent were Chinese. Most participants were employed (62.3 percent), and 34.8 percent held qualifications at undergraduate and postgraduate levels.
“Future research should explore how probable OCD relates to formal clinical diagnoses and how varying levels of symptom severity influence functioning across other life domains,” the authors said. “Insights on these relationships will aid in the design of sustainable youth mental health support frameworks.”