Obsessive Compulsive and Related Disorders

OCD: Core Criteria

Obsessions, Compulsions, or Both

OCD: Obsessions?

Recurrent, intrusive, unwanted thoughts/urges/images that cause anxiety, which the person tries to suppress/neutralize.

OCD: Compulsions?

Repetitive behaviors (checking, washing) OR mental acts (counting, praying) performed in response to an obsession or rigid rule.

OCD: Compulsion Key Distinction?

Acts are not realistically connected to the feared event, or they are clearly excessive.

OCD: Impact Threshold?

Symptoms are time-consuming ($>1$ hour/day) OR cause significant distress/impairment.

OCD: Insight Levels?

Good/Fair: Recognizes beliefs are probably untrue. Poor: Thinks beliefs are probably true. Absent/Delusional: Completely convinced beliefs are true.

BDD(Body Dysmorphic Disorder): Core Criterion A?

Preoccupation with one or more perceived defects/flaws in appearance that are unobservable or appear slight to others.

Body Dysmorphic Disorder (BDD): Core Criterion B (Behaviors)?

Performs repetitive acts (e.g., mirror checking, excessive grooming, comparing appearance) in response to the preoccupation.

BDD: Exclusion D?

Not better explained by concerns with body fat/weight if symptoms meet criteria for an Eating Disorder.

BDD: Muscle Dysmorphia?

Specifier for preoccupation with the body build being too small or insufficiently muscular.

Hoarding: Core Criterion A & B?

Persistent difficulty discarding possessions (regardless of value) due to a perceived need to save and distress when discarding.

Hoarding: Core Criterion C (Result)?

Accumulation leads to clutter that compromises the intended use of active living areas.

Hoarding: Excessive Acquisition?

Specifier where difficulty discarding is accompanied by excessive buying/collecting of unneeded items.

Hoarding: Insight Levels?

Good/Fair: Recognizes hoarding is problematic. Poor/Absent: Convinced hoarding is not problematic despite evidence.

Trichotillomania (Hair-Pulling): Core A & B?

Recurrent pulling out of hair leading to loss, with repeated attempts to stop.

Excoriation (Skin-Picking): Core A & B?

Recurrent picking at skin leading to lesions/damage, with repeated attempts to stop.

Trich/Excoriation: Core C?

The behavior causes clinically significant distress or impairment in functioning.

Substance/Medication-Induced: Core A?

Prominent OC/Related Symptoms (obsessions, picking, pulling, etc.) dominate the clinical picture.

Substance/Medication-Induced: Core B?

Symptoms developed during or soon after intoxication/withdrawal/medication exposure, and the substance is capable of causing them.

Substance/Medication-Induced: Exclusion C?

Not better explained by an independent disorder (e.g., symptoms precede substance, persist for $\approx 1$ month after withdrawal).

Substance/Medication-Induced: Specifiers?

Specify Onset: During intoxication, during withdrawal, or after medication use.

Medical Condition-Induced: Core A?

Prominent OC/Related Symptoms (obsessions, hoarding, picking, BDD-like symptoms) dominate the clinical picture.

Medical Condition-Induced: Core B?

Evidence shows the disturbance is the direct pathophysiological consequence of another medical condition.

Medical Condition-Induced: Specifier?

Specify Predominant Symptom Type (e.g., With hoarding symptoms, With appearance preoccupations).