Obsessive-compulsive thoughts are defined as the following: Recurrent or persistent obsessive or inappropriate thoughts, impulses, or imaginations that cause significant anxiety or depression. These thoughts, impulses, and imagery are not excessive concerns about real life problems. The individual tries to ignore, repress, or use other thoughts or behaviors to neutralize these thoughts, impulses, or imaginations The individual recognizes that these thoughts, impulses, and imaginations are the result of his or her own internal activities (not imposed or instilled from outside) Compulsive behaviors are defined as the following: The individual feels driven to perform certain repetitive actions (e.g., washing hands, sorting, checking) or mental actions (e.g., praying, counting, meditating on words) in order to respond to a compulsion words) in order to respond to some compulsive idea or to strictly follow some rule The repetitive actions or mental actions are performed to prevent or alleviate pain or to prevent some terrible thing or situation from happening. These actions are not realistically related to the original purpose of alleviating or preventing pain, or are overused. Adult individuals sometimes realize that obsessive-compulsive ideas and compulsive behaviors are absurd, but children do not have this awareness. Obsessive thoughts or compulsive behaviors bring considerable tension and take up time (more than an hour a day) that can impair the patient’s social and academic functioning.