Diagnosing Obsessive-Compulsive Disorder (OCD)

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)¹ is used by mental health professionals to help diagnose obsessive-compulsive disorder (OCD).

1. Either Obsessions or Compulsions
   
   

Obsessions are defined by (A), (B), (C), and (D):

1. 1. The person has thoughts, impulses, or images that occur over and over again. The person does not want to have these thoughts, impulses, or images. They cause a lot of anxiety or stress.
   2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.
   3. The person tries to ignore the thoughts, impulses, or images.
   4. The person knows that the thoughts, impulses, or images are only in his or her mind.

Compulsions are defined by (A) and (B):

1. 1. The person repeats behaviors (for example, handwashing, placing things in a specific order, or checking things over and over, like whether a door is locked) or thoughts (for example, praying, counting, or repeating words silently) over and over again or according to certain rules that must be followed exactly in order to make an obsession go away.
   2. The purpose of the behaviors or thoughts is to prevent or reduce distress, or prevent some feared event or situation. However, these behaviors or thoughts either are not connected to reality or clearly are extreme.
      
      

2. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable (note: this does not apply to children).
   
   
3. The obsessions or compulsions cause extreme distress, are time-consuming (take more than an hour a day), or significantly interfere with the person’s daily life.
   
   
4. If the person has another disorder at the same time, the obsessions or compulsions are not related just to the additional disorder. For example, in order to be diagnosed with OCD, a person with an eating disorder must have obsessions or compulsions that are not related just to food.
   
   
5. The illness is not due to taking medicine or other drugs.

For More Information

National Institute on Mental Health - Information on OCD

References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 4th ed. Washington, DC; 2000.