Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS
Yes, autism vs OCD can be a source of diagnostic error, as both conditions can involve structured actions, strong interests, and patterned behaviour. However, the causes and emotional drivers behind these traits are different leading to clinical confusion when not properly evaluated.
In autism, repetitive behaviour is often a way to self-soothe, manage sensory input, or add predictability to daily life. In contrast, OCD compulsions are driven by anxiety and performed to relieve intrusive thoughts. Without recognising this distinction, autistic traits can be mistaken for signs of OCD, resulting in an inaccurate diagnosis and inappropriate treatment.
Traits That Can Be Misunderstood
Below are some behavioural patterns that are often misread during assessment:
Routines and Rituals
Autistic routines are generally comforting and consistent, while OCD rituals stem from fear or anxiety linked to specific triggers.
Focused Thinking
Autism may involve deep interest in specific subjects for enjoyment. In OCD, obsessions are typically distressing and unwanted, this highlights key obsession differences.
Rule-Following or Rigidity
An autistic person may follow personal rules for comfort, not because they believe harm will occur if they don’t, unlike those with OCD.
Getting the diagnosis right requires careful consideration of behaviour context, emotional intent, and developmental history.
Visit providers like Autism Detect for personal consultations.
For a deeper dive into the science, diagnosis, and full treatment landscape,read our complete guide to misdiagnosis and differential diagnosis.
Beatrice Holloway, MSc
Author
Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.
All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.
Dr. Rebecca Fernandez, MBBS
Reviewer
Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.
All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.
