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Obsessive-Compulsive Disorder (OCD)
OCD is an anxiety disorder involving obsessions (unwanted, uncontrollable, repetitive thoughts), and compulsions (recurrent, "driven" patterns of ritual-like behavior). Obsessions are persistent thoughts, images, impulses, or ideas that run through one's mind even though they are meaningless or unwanted. Compulsions are urges to perform certain ritualized behaviors to counteract or prevent an obsessive concern or fear.
Some common obsessions are fear of becoming dirty or contaminated, fear of having an uncontrollable urge to harm someone close, or fear of a disaster. Some examples of compulsions would be washing, counting, checking, or arranging objects.
Some people have compulsions without obsessions, or obsessions without compulsions.
People with OCD also typically have trouble with getting thoughts "stuck" in their head... such as a worry about the day, the feeling that they look odd while out, one symptom or one thing wrong with them, etc. They also have a tendency to want to categorize things and want things to be definite and proven. People with OCD can dislike certain sensations and are prone to be perfectionists.
OCD ranges in severity from so severe that the person does nothing but perform rituals all day, to mild enough that the person is never driven to treatment. In rare cases, mild OCD can be treated through behavioral therapy alone, while most patients need medications.
OCD is treated through use of drugs and behavioral therapy. Common drugs used to treat OCD are anti-obsessive drugs such as fluvoxamine, fluoxetine, and clomipramine. Other drugs such as lithium, fenfluarmine and buspirone have been shown to augment anti-obsessitional drugs. Anti-depressives are also used, since a common part of OCD is depression.
OCD sufferers can recognize that their obsessions and compulsions are abnormal (may be absent in children). OCD symptoms take hours daily, interfere with a normal life, or are extremely distressing.
Diagnostic Criteria
- Either obsessions or compulsions:
Obsessions as defined by (1), (2), (3), and (4):
- 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 (not imposed from without as in thought insertion)
Compulsions as defined by (1) and (2):
- repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) 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
- 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.
- The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.
- If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
- The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Specify if:
With Poor Insight: if, for most of the time during the current episode the person does not recognize that the obsessions and compulsions are excessive or unreasonable
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Associated Features
- Depressed Mood
- Somatic/Sexual Dysfunction
- Guilt/Obsession
- Addiction
- Anxious/Fearful/Dependent Personality
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Differential Diagnosis
Anxiety Disorder Due to a General Medical Condition; Substance-Induced Anxiety Disorder; Body Dysmorphic Disorder; Specific Phobia; Social Phobia; Trichotillomania; Major Depressive Episode; Generalized Anxiety Disorder; Hypochondriasis; Specific Phobia; Delusional Disorder; Psychotic Disorder Not Otherwise Specified; Schizophrenia; Tic Disorder; Stereotypic Movement Disorder; Eating Disorders; Paraphilias; Pathological Gambling; Alcohol Dependence; Alcohol Abuse; Obsessive-Compulsive Personality Disorder; Superstitions; repetitive checking behaviors.
Think you might have OCD?
Try this online diagnostic tool as a supplement to seeking help from a professional.
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