Diagnosis of Obsessive Compulsive Disorder

By  , Expert Content
Aug 27, 2012

Obsessive compulsive disorder is diagnosed based on medical and psychiatric histories, physical exam and medical and psychological tests and exams. The tests and exams can help to confirm the underlying cause of your symptoms and initiate treatment.

Medical history: The diagnosis and evaluation of OCD involves a detailed history of the person and interview of the family members. Some of the questions that the health professional may ask include:

  • History of obsessive behaviours, such as washing hands excessively, checking locks and doors again and again, obsessed about keeping everything in place
  • Recurrent and persistent thoughts, impulses or images that cause anxiety, distress or are disturbing
  • History of other psychological problems (such as depression, anxiety)

Physical exam: The doctor will take the measurement of your height and weight; check other important parameters, such as heart rate, breathing rate, blood pressure and temperature; listen to your heart and lungs and specifically note your behaviour and manners.

Laboratory tests: The doctor may recommend blood tests, such as complete blood count (CBC) along with other blood tests that may help to rule out other medical problems that can cause similar symptoms, screen for alcohol and drugs and if needed, do imaging studies, such as an MRI or CT scan to rule out some pathological lesion in the brain.

Psychological evaluation: If mental health disorder is suspected, your doctor will check your mental status by observing the appearance and behaviour and enquiring about your feelings, thoughts, moods and substance abuse. The detailed psychological evaluation will include questions regarding your symptoms, such as when the symptoms started, how severe they are, how much affect they have on your daily life and if you've had similar symptoms in the past.

Diagnostic criteria for obsessive-compulsive disorder: If OCD is suspected, you will be referred to mental health professionals (a psychologist or psychiatrist), who will carry out a more detailed assessment of your symptoms. Obsessive-compulsive disorder is diagnosed if the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) are fulfilled. This is the standard manual used by mental health providers to diagnose mental conditions. It has been published by the American Psychiatric Association.

OCD is diagnosed if the following general criteria are met:

  • The affected person must have either obsessions or compulsions.
  • He or she must realise that his/her obsessions and compulsions are excessive or unreasonable.
  • Obsessions and compulsions significantly interfere with the person’s daily life.

Obsessions must meet following criteria:

  • Recurrent and persistent thoughts, impulses or images interfere with your daily functioning and cause distress.
  • Thoughts aren't basically undue worries relating to real problems of life.
  • You make an effort to ignore or suppress these thoughts, images or impulses.
  • You realise that the thoughts, images and impulses are a creation of your own mind.

Compulsions must meet the following criteria:

  • You have repetitive behaviour that you feel compelled to perform, such as wash hands again and again or check the door and lock repetitively.
  • These behaviours or mental acts reduce or prevent anxiety or distress.

Obsessive-compulsive disorder can be difficult to diagnose as similar symptoms can be observed in people with several mental health illness, such as generalised anxiety disorder, depression and schizophrenia.



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