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==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, [[compulsion]]s 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.<ref name="DSMV">{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref><ref name="pmid28384832">{{cite journal| author=Hirschtritt ME, Bloch MH, Mathews CA| title=Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. | journal=JAMA | year= 2017 | volume= 317 | issue= 13 | pages= 1358-1367 | pmid=28384832 | doi=10.1001/jama.2017.2200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28384832  }} </ref>
 
==Diagnostic Criteria==
==Diagnostic Criteria==
The phrase "obsessive-compulsive" has worked its way into the wider English lexicon, and is often used in an offhand manner to describe someone who is meticulous or absorbed in a cause (see also "[[Anal retentive|anal-retentive]]"). Such casual references should not be confused with obsessive-compulsive disorder; see [[clinomorphism]]. It is also important to '''distinguish''' OCD from other types of[[anxiety]], including the routine [[tension]] and [[Stress (medicine)|stress]] that appear throughout life. Although these signs are often present in OCD, a person who shows signs of infatuation or[[fixation]] with a subject/object, or displays traits such as [[Perfectionism (psychology)|perfectionism]], does not necessarily have OCD, a specific and well-defined condition.


To be diagnosed with obsessive-compulsive disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the [[Diagnostic and Statistical Manual of Mental Disorders|DSM-IV-TR]] diagnostic criteria. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) describes these obsessions and compulsions:<ref name="Quick">''Quick Reference to the Diagnostic Criteria from DSM-IV-TR''. Arlington, VA: American Psychiatric Association, 2000.</ref>
===DSM-V Diagnostic Criteria for Obsessive Compulsive Disorder<ref name="DSMV">{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>===
{{cquote|
 
*A. Presence of obsessions, [[compulsion]]s, 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.
<SMALL>''Note: Young children may not be able to articulate the aims of these behaviors or mental acts.''</SMALL>
 
'''''AND'''''
 
*B. The obsessions or [[compulsion]]s 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 disorder| 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 [[addiction|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:


'''Obsessions are defined by:'''
*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.
# Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
# The thoughts, impulses, or images are not simply excessive worries about real-life problems.
# The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
# The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
# The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.


'''Compulsions are defined by:'''
*With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.
# Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
# The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.


In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause[[impairment]] in social, occupational, or school functioning.<ref name="Quick"> </ref> OCD often causes feelings similar to those of [[Depression (mood)|depression]].
*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: ===
{| class="wikitable"
!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
|}
+<small>Adopted from JAMA<ref name="pmid28384832">{{cite journal| author=Hirschtritt ME, Bloch MH, Mathews CA| title=Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. | journal=JAMA | year= 2017 | volume= 317 | issue= 13 | pages= 1358-1367 | pmid=28384832 | doi=10.1001/jama.2017.2200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28384832  }} </ref></small>


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Psychiatry]]
[[Category:Psychiatry]]
[[Category:primary care]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs overview]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Latest revision as of 22:59, 29 July 2020

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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.[1][2]

Diagnostic Criteria

DSM-V Diagnostic Criteria for Obsessive Compulsive Disorder[1]

“
  • 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

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[2]

References

  1. ↑ 1.0 1.1 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. ↑ 2.0 2.1 Hirschtritt ME, Bloch MH, Mathews CA (2017). "Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment". JAMA. 317 (13): 1358–1367. doi:10.1001/jama.2017.2200. PMID 28384832.

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