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Obsessive Compulsive
Obsessive Compulsive and Related Disorders
| Question | Answer |
|---|---|
| Obsessions | Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted |
| Compulsions | Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly |
| Obsessive-Compulsive Disorder | The characteristic symptoms of OCD are the presence of obsessions and compulsions. Obsessions are repetitive and persistent thoughts (e.g., of contamination), images (e.g., of violent or horrific scenes), or urges (e.g., to stab someone). Importantly, obsessions are not pleasurable or experienced as voluntary: they are intrusive and unwanted and cause marked distress or anxiety in most individuals. |
| Obsessive-Compulsive Disorder (Criterion A - Obsessions, 1-2) | 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 some time 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). |
| Obsessive-Compulsive Disorder (Criterion A -Compulsions, 1-2) | Compulsions are defined by (1) and (2): 1. Repetitive behaviors 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. |
| Obsessive-Compulsive Disorder (Criterion B , C & D) | 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. 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. D. The disturbance is not better explained by the symptoms of another mental disorder |
| Obsessive-Compulsive Disorder (Specifiers) | 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. |
| Obsessive-Compulsive Disorder (Specifiers) | Tic-related: The individual has a current or past history of a tic disorder. |
| Body Dysmorphic Disorder | Individuals with body dysmorphic disorder (formerly known as dysmorphophobia) are pre- occupied with one or more perceived defects or flaws in their physical appearance, which they believe look ugly, unattractive, abnormal, or deformed (Criterion A). The perceived flaws are not observable or appear only slight to other individuals. Concerns range from looking “unattractive” or “not right” to looking “hideous” or “like a monster.” |
| Body Dysmorphic Disorder (Criterion A & B) | A. Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others. B. At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seek- ing) or mental acts (e.g., comparing his or her appearance with that of others) in response to the appearance concerns. |
| Body Dysmorphic Disorder (Criterion C & D) | C. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder. |
| Body Dysmorphic Disorder (Specifier) | With muscle dysmorphia: The individual is preoccupied with the idea that his or her body build is too small or insufficiently muscular. This specifier is used even if the individual is preoccupied with other body areas, which is often the case. |
| Body Dysmorphic Disorder (Specifier) | 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. |
| Hoarding Disorder | The essential feature of hoarding disorder is persistent difficulties discarding or parting with possessions, regardless of their actual value. The difficulty in discarding possessions refers to any form of discarding, including throwing away, selling, giving away, or recycling. The main reasons given for these difficulties are the perceived utility or aesthetic value of the items or strong sentimental attachment to the possessions. |
| Hoarding Disorder (Criterion A, B & C) | A. Persistent difficulty discarding or parting with possessions, regardless of their actual value. B. This difficulty is due to a perceived need to save the items and to distress associated with discarding them. C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties. |
| Hoarding Disorder (Criterion D, E & F) | D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others). E. The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi syndrome). F. The hoarding is not better explained by the symptoms of another mental disorder |
| Hoarding Disorder (Specifier) | With excessive acquisition: If difficulty discarding possessions is accompanied by excessive acquisition of items that are not needed or for which there is no available space. |
| Hoarding Disorder (Specifier) | 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. |
| Trichotillomania (Hair-Pulling Disorder) | The essential feature of trichotillomania (hair-pulling disorder) is the recurrent pulling out of one’s own hair. Hair pulling may occur from any region of the body in which hair grows; the most common sites are the scalp, eyebrows, and eyelids, while less common sites are axillary, facial, pubic, and peri-rectal regions. |
| Trichotillomania (Hair-Pulling Disorder) (Criterion A, B & C) | A. Recurrent pulling out of one’s hair, resulting in hair loss. B. Repeated attempts to decrease or stop hair pulling. C. The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Trichotillomania (Hair-Pulling Disorder) (Criterion D & E) | D. The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition). E. The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder). |
| Excoriation (Skin-Picking) Disorder | The essential feature of excoriation (skin-picking) disorder is recurrent picking at one’s own skin. The most commonly picked sites are the face, arms, and hands, but many individuals pick from multiple body sites. Individuals may pick at healthy skin, at minor skin irregularities, at lesions such as pimples or calluses, or at scabs from previous picking. Most individuals pick with their fingernails, although many use tweezers, pins, or other objects. |
| Excoriation (Skin-Picking) Disorder (Criterion A, B & C) | A. Recurrent skin picking resulting in skin lesions. B. Repeated attempts to decrease or stop skin picking. C. The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Excoriation (Skin-Picking) Disorder (Criterion D & E) | D. The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies). E. The skin picking is not better explained by symptoms of another mental disorder (e.g.,delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in non-suicidal self-injury). |
| Substance/Medication-Induced Obsessive-Compulsive and Related Disorder | The essential features of substance/medication-induced obsessive-compulsive and related disorder are prominent symptoms of an obsessive-compulsive and related disorder that are judged to be attributable to the effects of a substance. The obsessive-compulsive and related disorder symptoms must have developed during or soon after substance intoxication or withdrawal or after exposure to a medication or toxin, and the substance/medication must be capable of producing the symptoms |
| Substance/Medication-Induced Obsessive-Compulsive and Related Disorder (Criterion A) | A. Obsessions, compulsions, skin picking, hair pulling, other body-focused repetitive behaviors, or other symptoms characteristic of the obsessive-compulsive and related dis- orders predominate in the clinical picture. |
| Substance/Medication-Induced Obsessive-Compulsive and Related Disorder (Criterion B) | B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2): 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication. 2. The involved substance/ medication is capable of producing the symptoms in Criterion A. |
| Substance/Medication-Induced Obsessive-Compulsive and Related Disorder (Criterion C) | C. The disturbance is not better explained by an obsessive-compulsive related disorder not substance/medication-induced. Such evidence of an independent obsessive-compulsive and related disorder could include the following: The symptoms precede the substance/medication use; the symptoms persist for a substantial period of time after the cessation; or there is other evidence suggesting the existence of an independent non-substance/medication-induced obsessive-compulsive and related disorder. |
| Substance/Medication-Induced Obsessive-Compulsive and Related Disorder (Criterion D & E) | D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Obsessive-Compulsive and Related Disorder Due to Another Medical Condition | The essential feature of obsessive-compulsive and related disorder due to another medical condition is clinically significant obsessive-compulsive and related symptoms that are judged to be best explained as the direct pathophysiological consequence of another medical condition. The judgment that the symptoms are best explained by the associated medical condition must be based on evidence from the history, physical examination, or laboratory findings. |
| Obsessive-Compulsive and Related Disorder Due to Another Medical Condition (Criterion A & B) | A. Obsessions, compulsions, preoccupations with appearance, hoarding, skin picking, hair pulling, other body-focused repetitive behaviors, or other symptoms characteristic of obsessive-compulsive and related disorder predominate in the clinical picture. B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition. |
| Obsessive-Compulsive and Related Disorder Due to Another Medical Condition (Criterion C, D & E) | C. The disturbance is not better explained by another mental disorder. D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. |
| Obsessive-Compulsive and Related Disorder Due to Another Medical Condition (Specifier) | With obsessive-compulsive disorder–like symptoms: If obsessive-compulsive dis- order–like symptoms predominate in the clinical presentation. With appearance preoccupations: If preoccupation with perceived appearance de- fects or flaws predominates in the clinical presentation. |
| Obsessive-Compulsive and Related Disorder Due to Another Medical Condition (Specifier) | With hoarding symptoms: If hoarding predominates in the clinical presentation. With hair-pulling symptoms: If hair pulling predominates in the clinical presentation. With skin-picking symptoms: If skin picking predominates in the clinical presentation. |
| Other Specified Obsessive-Compulsive and Related Disorder | This category applies to presentations in which symptoms characteristic of an obsessive- compulsive and related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the obsessive-compulsive and related disorders diagnostic class. |
| Other Specified Obsessive-Compulsive and Related Disorder (Specifier 1-2) | 1. Body dysmorphic–like disorder with actual flaws: This is similar to body dysmorphic disorder except that the defects or flaws in physical appearance are clearly observable by others. The preoccupation with these flaws is clearly excessive and causes significant impairment or distress. 2. Body dysmorphic–like disorder without repetitive behaviors: The individual has not performed repetitive behaviors or mental acts in response to the appearance concerns. |
| Other Specified Obsessive-Compulsive and Related Disorder (Specifier 3) | 3. Body focused repetitive behavior disorder: This is characterized by recurrent body- focused repetitive behaviors and repeated attempts to decrease or stop the behaviors. These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning and are not better explained by trichotillomania, excoriation disorder, stereotypic movement disorder, or non-suicidal self-injury. |
| Other Specified Obsessive-Compulsive and Related Disorder (Specifier 4) | Obsessional jealousy: This is characterized by non-delusional preoccupation with a partner’s perceived infidelity. The preoccupations may lead to repetitive behaviors or mental acts in response to the infidelity concerns; they cause clinically significant dis- tress or impairment in social, occupational, or other important areas of functioning; and they are not better explained by another mental disorder such as delusional disorder, jealous type, or paranoid personality disorder. |
| Other Specified Obsessive-Compulsive and Related Disorder (Specifier 5-7) | 5. Shubo-kyofu: A variant of taijin kyofusho that is similar to body dysmorphic disorder and is characterized by excessive fear of having a bodily deformity. 6. Koro: Related to dhat syndrome an episode of sudden and intense anxiety that the penis (or the vulva and nipples in females) will recede into the body, possibly leading to death. 7. Jikoshu-kyofu: A variant of taijin kyofusho characterized by fear of having an offensive body odor (also termed olfactory reference syndrome). |
| Unspecified Obsessive-Compulsive and Related Disorder | This category applies to presentations in which symptoms characteristic of an obsessive-compulsive and related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in this diagnostic class. The category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met and insufficient information to make a diagnosis |
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amdressler
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