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OCD Diagnosis: OCD Criteria and Characteristics in DSM 5

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An obsessive-ompulsive disorder diagnosis can only come from a qualified mental health professional. To receive an OCD diagnosis, you must meet certain diagnostic criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). If you receive an OCD diagnosis, it means that you have a chronic mental illness that will require lifelong management. There are effective ways to treat and manage OCD and many people with the disorder live productive, happy lives.

Obsessive-Compulsive Disorder Diagnosis

The newly updated DSM-5 (OCD in DSM-5) acts as a manual for mental health professionals in giving an obsessive-compulsive disorder diagnosis. Unlike physical diseases and illnesses, doctors don't have specific laboratory tests available to diagnose mental illness, such as OCD.

First, he or she will probably run a series of medical tests that include psychological and physical exams as well as laboratory tests. During the physical examination, the doctor will likely check:

  • Height and weight
  • Heart rate
  • Blood pressure
  • Body temperature
  • Heart and lung sounds
  • Abdominal area

She may order some laboratory tests like a blood draw. The blood test will check your complete blood count (CBC) and look for things like alcohol or drugs in your blood. Frequently, the physician will check for thyroid problems by blood test as well. (Read: OCD and Related Disorder Due to Medical Condition)

They perform the physical exam and laboratory tests to rule out things, such as alcohol, drugs, thyroid gland issues, and other health problems. These things could cause symptoms that temporarily mimic OCD. (Read: Substance, Medication Induced OCD and Related Disorder)

Your mental health provider will conduct a psychological evaluation to see if you might meet the criteria for obsessive compulsive-disorder. During the evaluation, the doctor will ask you about a number of things, including:

  • Your thoughts, feelings, and behaviors
  • Your symptoms
  • When symptoms began
  • Severity of symptoms (from your point of view)
  • How they affect your daily life
  • Similar past episodes
  • If you've had thoughts of suicide, harming yourself, or others

The doctor may also want to talk to your family or close friends and also find out your family mental health history and whether other family members have OCD or any other mental illness.

Specific Obsessive-Compulsive Disorder Criteria

The physician or mental health professional will determine whether you meet the specific obsessive-compulsive disorder criteria listed in the DSM-5, during the psychological evaluation portion of your visit. Your symptoms must meet both the general and specific characteristics of obsessive compulsive disorder.

To receive an OCD diagnosis, you must meet these general criteria:

  • You must have obsessions and compulsions
  • The obsessions and compulsions must significantly impact your daily life
  • You may or may not realize that your obsessions and compulsions are excessive or unreasonable

Your obsessions must meet specific criteria:

  • Intrusive, repetitive and persistent thoughts, urges, or images that cause distress
  • The thoughts do not just excessively focus on real problems in your life
  • You unsuccessfully try to suppress or ignore the disturbing thoughts, urges, or images
  • You may or may not know that your mind simply generates these thoughts and that they do not pose a true threat

Your compulsions must meet specific criteria:

  • Excessive and repetitive ritualistic behavior that you feel you must perform, or something bad will happen. Examples include hand washing, counting, silent mental rituals, checking door locks, etc.
  • The ritualistic compulsions take up a least one hour or more per day
  • You perform these physical rituals or mental acts to reduce the severe anxiety caused by the obsessive thoughts.

Challenges in Obsessive-Compulsive Disorder Diagnosis

Doctors face some challenges in making an obsessive-compulsive disorder diagnosis. The symptoms can appear similar to those associated with anxiety disorder, clinical depression, schizophrenia, and a number of other mental illnesses. Some drugs or other medical conditions can also mimic the symptoms of OCD. It's important that your physician carefully evaluate the results of the tests, exams and psychological evaluation to determine whether you have OCD or another condition.

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next: OCD Causes: Is OCD Genetic, Hereditary?
~ all ocd articles

Last Updated: 03 February 2017
Reviewed by Harry Croft, MD

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