The rates of obsessive-compulsive disorder (OCD) in several epidemiological studies have been surprisingly high, up to 2.5% of the general population. Broad diagnostic criteria and lay interviewers may have led to overcounting. Many people have intrusive thoughts and ritualized behaviors, but generally these do not interfere with our lives. Crino et al. (p. 876) report an Australian survey of 10,641 adults that included only obsessions or compulsions causing marked distress, consuming substantial time, and interfering with functioning. By these standards, OCD was present in 0.6% of the population. OCD was often accompanied by other psychiatric disorders, but substance abuse was less common than in other surveys. Compared to earlier diagnostic systems, the current criteria were more likely to identify people who are disabled, receive medical services, and are unemployed. This suggests a more accurate identification of people with true illness.