From the Guidelines
The DSM-5-TR criteria for Obsessive-Compulsive Disorder (OCD) requires the presence of obsessions, compulsions, or both, as defined by specific characteristics and resulting in significant distress or impairment. The diagnostic criteria for OCD, as outlined in the DSM-5-TR, include several key components [ 1 ].
- Obsessions are defined as recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, causing marked anxiety or distress.
- The individual attempts to ignore or suppress these obsessions or neutralize them with some other thought or action (a compulsion).
- Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rigid rules. These behaviors or mental acts aim to prevent or reduce anxiety or distress, or prevent some dreaded event, but are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive [ 1 ]. The obsessions or compulsions must be time-consuming (taking more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning [ 1 ]. Additionally, these symptoms cannot be attributable to the physiological effects of a substance, medical condition, or better explained by another mental disorder, such as generalized anxiety disorder, body dysmorphic disorder, or schizophrenia spectrum and other psychotic disorders [ 1 ]. It is essential to accurately diagnose OCD using these criteria to provide appropriate treatment and improve the patient's quality of life [ 1 ].
From the Research
Diagnostic Criteria for Obsessive-Compulsive Disorder (OCD)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria for Obsessive-Compulsive Disorder (OCD) include:
- Significant impairment of cognitive-behavioral inhibition, which is causally associated with cognitive processes evoking anxiety, along with increased desire for perfect control over the possible harm 2
- Presence of obsessions, compulsions, or both, which are time-consuming, cause significant distress, and interfere with social, occupational, or other areas of functioning 3, 4, 5, 6
- Specifiers to delineate the presence of tics and degree of insight, such as good, poor, or absent insight 4, 6
Changes in DSM-5
The DSM-5 has made significant changes to the classification and diagnostic criteria of OCD, including:
- Moving OCD out from under the Anxiety Disorder section into a new category: Obsessive Compulsive and Related Disorders 4, 5, 6
- Adding two new specifiers: a modification of one specifier (insight) and the addition of a new tic specifier 4
- Recognizing the importance of avoidance and thought stopping beyond compulsions as other strategies to deal with obsessions 4
Related Disorders
OCD-related disorders include: