A 2-year prospective follow-up of a community-based sample of adolescents previously diagnosed as having obsessive compulsive disorder (OCD) or "obsessive compulsive spectrum" disorder and a control sample was completed by clinicians experienced with OCD but blind to prior diagnosis. An initial diagnosis of OCD or "other psychiatric disorder with OC features" was most likely to predict a diagnosis of OCD at follow-up. Subclinical OCD at baseline did not strongly predict continuing psychopathology. A prior diagnosis of obsessive-compulsive personality predicted continued obsessive-compulsive symptoms but its relationship to OCD remains obscure.