How Is OCD Diagnosed?
As with most other psychiatric disorders, there is no simple blood test or x-ray available today that can easily diagnose OCD. A doctor or therapist makes the diagnosis if he or she believes there is sufficient evidence. Some medical problems can cause symptoms that look similar to those of OCD. Tic disorders or seizure disorders can cause repetitive movements that may sometimes look like compulsive behaviors. Various other psychiatric conditions can cause OCD-like symptoms too, so the treating doctor or therapist must be familiar with the specific criteria used to distinguish OCD from other diseases.
What Are the DSM-IV Criteria for OCD?
The DSM-IV-TR, or Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision, published by the American Pychiatric Association, is the official "guidebook" for diagnosing psychiatric disorders. The criteria for OCD, as listed in the DSM-IV-TR, are summaraized as follows:
A. Either obsessions or compulsions:
Obsessions are defined as:
- recurrent and persistent thoughts, impulses or images that may be intrusive, inappropriate or provoking anxiety or distress
- the thoughts, impulses or images are not just excessive worries about real-life problems
- the person attempts to ignore or suppress the obsessions, or to neutralize them with some other thought or action
- the person realizes that the obsessions are a product of his or her own mind
Compulsions are defined as:
- repetitive behaviors (like hand washing or checking) or mental acts (like counting, praying or 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 act or situation in a way that is unrealistic or excessive
B. At some point, the person has realized that their obsessions/compulsions are excessive or unreasonable (although children with OCD do not need this criterion).
C. The obsessions or compulsions:
- cause distress,
- are time-consuming (for example, take more than an hour a day),
- or significantly interfere with other activities (like work, relationships, or daily routines)
D. The obsessions/compulsions are not due to another psychiatric disorder (like an eating disorder).
E. The obsessions/compulsions are not due to substance use (like drugs) or a medical problem (like a seizure disorder).
Screening Tests
After discussing your symptoms with you, your doctor or therapist may decide to administer a written questionnaire for OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is probably the most widely used ratings scale for OCD. Test like the Y-BOCS are helpful in diagnosing OCD, determining how severe the symptoms are, and monitoring response to treatment.
If I Think I Have OCD, What Should I Do?
Treatment is available, and it can help tremendously. Start by finding a doctor or therapist with whom you feel comfortable. Medication and therapy are the mainstays of treatment for OCD.
Source: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.