Criteria for the Diagnosis of Obsessive–Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by obsessions or compulsions (or both) that are distressing, time-consuming, or substantially impairing.

Criteria for the Diagnosis of Obsessive–Compulsive Disorder (OCD)

Obsessions

  • Obsessions are recurrent thoughts, urges, or images that are experienced, at some time, as intrusive and unwanted.
  • The person 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

  • Compulsions are repetitive behaviors (e.g., hand washing, ordering, and checking) or mental acts (e.g., praying and counting) that the person feels driven to perform in response to an obsession.
  • The goal of the compulsive behavior is to prevent or reduce anxiety or distress or prevent some feared outcome.

Symptoms causing impairment

  • Obsessions or compulsions are time consuming (>1 hr/day).
  • There is clear evidence that the symptoms cause the person distress or interfere with or reduce the quality of social, academic, or occupational functioning.
  • Symptoms are not better accounted for by another mental disorder (e.g., depression or anxiety disorder) and are not solely attributable to the effects of a substance (e.g., a drug of abuse or medication).

Specifiers†

  • Insight specifier: Persons with OCD have varying levels of insight (i.e., ability to recognize that their beliefs are definitely or probably not true); poorer insight (when the person is mostly convinced that their beliefs and behaviors are not problematic, despite evidence to the contrary) has been associated with poor long-term outcome.
  • Tic-related specifier: When a person has a tic disorder or history of a tic disorder, this specifier reflects possible different patterns of coexisting conditions, course of illness, and familial transmission.

† Specifiers clarify features of the disorder but are not required for a diagnosis.

 

 

References:

  1. Grant JE. Clinical practice: Obsessive-compulsive disorder. N Engl J Med. 2014 Aug 14;371(7):646-53. [Medlline]
  2. Voderholzer U, Hauer M, Stattrop U. To identify and treat obsessive-compulsive disorders: an overview. MMW Fortschr Med. 2013 Sep 12;155(15):37-9. [Medline]
  3. Leckman JF, Denys D, Simpson HB, Mataix-Cols D, Hollander E, Saxena S, Miguel EC, Rauch SL, Goodman WK, Phillips KA, Stein DJ. Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V. Depress Anxiety. 2010 Jun;27(6):507-27. [Medline]

Created Sep 01, 2014.

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