Obsessive-compulsive disorder diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sonya Gelfand; Kiran Singh, M.D. [2]

Overview

The diagnosis of obsessive compulsive disorder is based on clinical assessment. Obsessive compulsive disorder is diagnosed according to the DSM-V guidelines, by the presence of obsessions, compulsions or both. The symptoms must be time consuming, causing significant impairment of normal life activities and not being associated with a psychological disorder or substance abuse. Lastly, the symptoms must not fall into any other category of mental disorders to classify them as an obsessive compulsive disorder.

Diagnostic Criteria

DSM-V Diagnostic Criteria for Obsessive Compulsive Disorder

“

A. Presence of obsessions, compulsions, or both: Obsessions are defined by (1) and (2): 1. Recurrent and persistent thoughts, urges, or images that are experienced, at sometime during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. 2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion). Compulsions are defined by (1) and (2): 1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress,or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Note: Young children may not be able to articulate the aims of these behaviors or mental acts. AND B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. AND C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. AND D. The disturbance is not better explained by the symptoms of another mental disorder(e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance,as in body dysmorphic disorder; difficulty discarding or parting with possessions,as in hoarding disorder; hair pulling, as in trichotillomania hair-pulling disorder;skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies,as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders;guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder). Specify if: With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true. With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true. Specify if: Tic-related: The individual has a current or past history of a tic disorder.

”

Common Obsessions and Related Compulsions in OCD:

Obsessions	Related Compulsions
Fear of contamination	Repeated cleaning or washing
Continuous doubting	Repeated checking
Thoughts that are violent or sexual	Repeated thoughts of "undoing"
Fear of inflicting injury to others	Repeatedly actions to check for injured indivuials
Prsesnce of symmetry	Repeated rearrangement and reordering
Religious scurpulosity	Repeated religious acts
Superstitions related to "luck"	Repeated superstitions to invite luck

+Adopted from JAMA