Symptoms of Obsessive Compulsive Disorder (OCD)and how it is diagnosed

Obsessive Compulsive Disorder (OCD) is an Anxiety Disorder which has as its main characteristics obsessive thoughts and ideas, which are sometimes accompanied by compulsive behaviors and actions, often designed to ward off the obsessive thoughts.

There are currently no medical tests which can diagnose OCD. Diagnosis is usually based on information about symptoms as well as clinical observation. Diagnosis of OCD can be made by Psychiatrists, Clinical Psychologists, medical Doctors, Pediatricians or by a multi-disciplinary team.

In order to make a formal diagnosis of OCD, the following symptoms must be present (DSM lV-TR)

Obsessions:

• Recurring and persistent ideas, thoughts or images that are often experienced as senseless, intrusive and difficult to control.
• Attempts to ignore or suppress these thoughts or to neutralize them with another thought or action.
• The person realizes that these thoughts, images or ideas are the product of his or her own mind, yet finds them almost impossible to resist.

Compulsions:

• Repetitive, intentional and often stereotyped behavior performed in response to an obsession or according to certain rules.
• Although the behavior is intended to neutralize or prevent some dreaded event or situation, it is clearly not connected in a realistic way with what it is designed to prevent or is excessive (e.g. repetitive hand washing in order to prevent death).
• The obsessions or compulsions cause a great deal of distress and anxiety, are time consuming (take more than an hour a day) or significantly interfere with the person's health, social or occupational functioning. The person is often secretive and may attempt to conceal the compulsive thoughts and behaviors.

While the above symptoms are necessary to make a formal diagnosis of OCD, they can be present in a less severe form. In this case, the person would not be diagnosed as suffering from a psychiatric disorder, but is rather said to have obsessive thoughts or compulsive behaviors.

This sometimes happens with Generalized Anxiety Disorder and Depression. Most people experience some obsessive thoughts and behaviors at some time in their lives, especially under stress.

In small children it is very common and quite normal (e.g. don't step on the cracks or the bears will get you!) to have some compulsive behaviors. In both adults and children, it is only when the above criteria are fulfilled and there is a great deal of anxiety and distress associated with the thoughts and behaviors that a formal diagnosis can be made.

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