Obsessive Compulsive Disorder (OCD)

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Diagnosis

There is no laboratory test for OCD. Diagnosis is made with the following:

• Close clinical examination of emotional past
• Criteria for diagnosis
• Current symptoms
• Differential diagnosis
• Examination of family history (see risk factors)

OCD can be mild or severe. There are four essential factors in the diagnosis of OCD that distinguish OCD from ordinary, mildly intrusive worries or brooding. They are the following:

1. Symptoms cause significant distress
2. Symptoms take up more than 1 hour a day
3. Symptoms significantly interfere with work, relationships, or daily functioning
4. The person recognizes that his or her obsessions and compulsions are unreasonable or excessive

Differential diagnosis of requires distinguishing OCD from other psychiatric disorders. The following psychiatric disorders feature symptoms that may, at first, resemble OCD:

• Major depressive disorder
• Other anxiety disorders
• Eating disorders
• Alcoholism or other substance-related disorders
• Tourette's syndrome
• Generalized anxiety disorder
• Specific phobia
• Schizophrenic delusions

All of these conditions are differentiated from OCD by type and severity of symptoms. For example, although schizophrenic delusions may resemble obsessions common in OCD, people experiencing delusions do not have insight into their content. They believe the delusions involve external influence and are not the product of their own mind. Some of these disorders may occur with OCD (see course and prognosis).

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