Could Adult Autism Signs Be Confused with OCD?

PostedNovember 6, 2025

UpdatedNovember 6, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, autism vs. OCD in adults can often be difficult to differentiate, as both conditions share similar behaviours that overlap in significant ways. Many adults with autism exhibit repetitive behaviours, rigid routines, and intense focus on specific topics, which are also commonly seen in obsessive-compulsive disorder (OCD). As a result, the symptoms of these two conditions can be mistaken traits, leading to potential diagnostic overlap.

While both autism and OCD involve a degree of repetitive behaviour, the underlying reasons for these actions are different. For instance, adults with autism may engage in repetitive behaviours like hand-flapping or following rigid routines as a means of self-regulation or comfort, often due to sensory sensitivities or social challenges. In contrast, individuals with OCD perform these actions in response to intrusive thoughts or obsessive fears. Understanding these differences is essential for proper diagnosis and treatment.

Common Symptoms of Autism and OCD Overlap

The common symptoms of autism and OCD that overlap are as follows:

Repetitive Behaviours:

Both conditions involve a tendency to engage in repetitive actions. For autism, these behaviours help manage anxiety or sensory overload, while in OCD, they are driven by obsessive thoughts. CBT can help manage these behaviours by targeting the root causes of the anxiety or distress behind them.

Strict Routines and Rigidity:

Adults with autism often thrive on routine and may become distressed by changes, similar to OCD behaviours. However, autism-related rigidity is more about comfort and predictability, while OCD routines are driven by compulsive thoughts. Therapy can help address both types of rigidity and reduce stress associated with disruptions.

For personalised support, visit providers like Autism Detect for personal consultations tailored to your needs.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to late diagnosis in adults.

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.