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Obsessive-Compulsive Disorder

DSM-IV Criteria

Either Obsessions or Compulsions are present
  1. Obsessions
    1. Recurrent, persistent thoughts, impulses or images experienced as intrusive and causing marked anxiety.
    2. The thoughts, impulses or images are not just excessive worries about real problems.
    3. The person attempts to ignore or suppress symptoms, or attempts neutralize them with some other thought or action.
    4. The person recognizes the thoughts, impulses or images as a product of his or her own mind.
  3. Compulsions
    1. Repetitive behaviors or acts that the person feels driven to perform in response to an obsession.
    2. These behaviors or mental acts are aimed at preventing distress or preventing some dreaded event, but they are not connected in a realistic way to what they are attempting to prevent, or they are clearly excessive.
  5. The person has recognized that the obsessions or compulsions are excessive or unreasonable.
  6. The obsessions or compulsions cause marked distress, take more than a hour a day, or significantly interfere with functioning.
  7. If another psychiatric disorder is present, the content of the symptoms is not restricted to the disorder (e.g., preoccupation with food in an eating disorder, or preoccupation with drugs in a substance abuse disorder).
  8. The disturbance is not due to a substance or medical condition.
  9. Specify if the patient has poor insight into his illness. Poor insight psychiatry is present if for most of the current episode, the person does not recognize the symptoms as excessive or unreasonable.
Clinical Features of Obsessive-Compulsive Disorder (OCD)
  1. Compulsions often occupy a large portion of an individuals day leading to marked functional impairment.
  2. Situations that provoke symptoms are often avoided, such as occurs when an individual with obsessions of contamination avoids touching anything that might be dirty.
  3. Patients are reluctant to discuss symptoms, leading to under diagnosis of this disorder.
  4. Depression is common in patients with OCD.
  5. Alcohol or sedative-hypnotic drug abuse to reduce distress is common.
  6. Washing and checking rituals are common in children with OCD who may not consider their behavior to be unreasonable or excessive.
  1. Lifetime prevalence of OCD is approximately 2.5%.
  2. There is no sex difference in prevalence, but the age of onset is earlier in males.
  3. OCD usually begins in