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Fig. 1

Photograph of damage to Maya’s hands resultant from behaviors related to obsessive-compulsive disorder. The background has been blurred to remove potentially identifying features.

Obsessive-compulsive disorder (OCD) in elite athletes can hide in plain sight. Unique stressors and the culture of sport (including socially acceptable superstitions and rituals) can create adaptive and maladaptive behaviors, which may conceal the presence of an illness. Superstitions, routines, and peculiar behaviors in sports are distinguishable from the features of OCD. OCD is a distinct mental health condition with potentially debilitating consequences for those afflicted, including athletes. Common comorbidities with and overlapping features with eating disorders, body dysmorphic disorder, and perfectionism may complicate identification and treatment. Interference by OCD symptoms in the functioning of an athlete can result in physical danger to the athlete, significant disruption in the training environment, and negative performance outcomes. Early detection and a comprehensive approach to management may mitigate the development of more severe pathology.

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