Clinical Classification of OCD
DSM
IV
(American Psychiatric Association, 1994), one of the two current psychiatric
classifications, categorises OCD alongside Phobias, Panic Disorder, Generalised
Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder as one of six
discriminate Anxiety Disorders.
With regard to the essential features of OCD, the manual states the following diagnostic criteria for Obsessive-Compulsive Disorder.
Diagnostic criteria for Obsessive-Compulsive Disorder.
A.
Either obsessions or compulsions:
Obsessions as defined by (1), (2), (3) and (4):
(1) recurrent and persistent thoughts, impulses, or images that are experienced,
at some time during the disturbance, as intrusive and inappropriate and
that cause marked anxiety or distress
(2) the thoughts, impulses, or images are not simply excessive worries
about real-life problems
(3) the person attempts to ignore or suppress such thoughts, impulses,
or images, or to neutralize them with some other thought or action
(4) the person recognizes that the obsessional thoughts, impulses, or
images are a product of his or her own mind (not imposed from without
as in thought insertion).
Compulsions as defined by (1) and (2):
(1) repetitive behaviours (e.g., hand washing, ordering, checking) or
mental acts (e.g., praying, counting, repeating words silently) that the
person feels driven to perform in response to an obsession, or according
to rules that must be applied rigidly
(2) the behaviours or mental acts are aimed at preventing or reducing
distress or preventing some dreaded event or situation; however, these
behaviours or mental acts either are not connected in a realistic way
with what they are designed to neutralize or prevent or are clearly excessive
.
B.
At some point during the course of the disorder, the person has recognized
that the obsessions or compulsions are excessive or unreasonable. Note:
This does not apply to children.
C.
The obsessions or compulsions cause marked distress, are time consuming
(take more than 1 hour a day), or significantly interfere with the person's
normal routine, occupational (or academic) functioning, or usual social
activities or relationships.
D.
If another Axis I disorder is present, the content of the obsessions or
compulsions is not restricted to it (e.g., preoccupation with food in
the presence of an Eating Disorders; hair pulling in the presence of Trichotillomania;
concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation
with drugs in the presence of a Substance Use Disorder; preoccupation
with having a serious illness in the presence of Hypochondriasis; preoccupation
with sexual urges or fantasies in the presence of a Paraphilia; or guilty
ruminations in the presence of Major Depressive Disorder).
E.
The disturbance is not due to the direct physiological effects of a substance
(e.g., a drug of abuse, a medication) or a general medical condition.
Specify if:
With
Poor Insight: if, for most of the time during the current episode,
the person does not recognize that the obsessions and compulsions are
excessive or unreasonable.
The APA (American Psychiatric Association) (1994) also provides a diagnostic index of OCD subtypes; the categories included are:
‘Cleaners’, ‘Repeaters’, ‘Completers’, ‘Checkers’, ‘Overly Meticulous’, ‘Compulsive Avoider's’, ‘Hoarders’, and ‘Slowness’.
Additional epidemiological facts about the disorder:The
ratio of men to women suffering with the disorder is 1:1, although, more
specifically, the disorder’s onset is reported to occur earlier
in men than women.
Studies
have demonstrated that at least a third of all adult sufferers have reported
it's onset as occurring during childhood or adolescence.
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