OCD Diagnosis: DSM-5 Criteria for Obsessive-Compulsive Disorder

OCD is diagnosed when obsessions and/or compulsions cause significant distress or impairment. DSM-5 criteria:

Diagnostic Criteria (Summary)

1. Obsessions: Recurrent, intrusive thoughts, urges, or images causing anxiety/distress. Not simply excessive worries. Attempts to ignore/suppress/neutralize.
2. Compulsions: Repetitive behaviors (handwashing, checking, ordering) or mental acts (counting, praying, repeating words) driven by obsessions or rigid rules. Aim to reduce distress or prevent dreaded event. Not realistically connected or clearly excessive.
3. Time/impact: Symptoms ≥1 hour/day OR cause clinically significant distress/impairment in social, occupational, or other functioning.
4. Not attributable: To substance, medical condition, or another mental disorder (e.g., GAD, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation, stereotypies).
5. Duration: Typically ≥6 months (though not a strict threshold in DSM-5).

Common Obsession Themes

• Contamination, harm, symmetry/order, taboo thoughts (sexual, religious), need for certainty.

Common Compulsions

• Washing/cleaning, checking, repeating, counting, ordering/arranging, mental rituals, reassurance seeking.

Differential Diagnosis

Distinguish from OCPD (personality trait), autism (restricted interests), psychosis (delusions), tic disorders.

Assessment

Y-BOCS (Yale-Brown Obsessive Compulsive Scale) quantifies severity. Diagnosis by psychiatrist/psychologist via clinical interview.