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Definition and diagnosis of Obsessive-compulsive disorder

A DSM-IV diagnosis of OCD is made if the person exhibits either obsessions or compulsions. Obsessions are indicated by the following:

1 The person has 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.

4The 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 are indicated by the following:

1 The person has repetitive behaviours (for example, hand washing, ordering, checking) or mental acts (for example, 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 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. Additionally, at some point during the course of the disorder, the person should have recognized that the obsessions or compulsions were excessive or unreasonable (however, this does not apply to children).

Finally, 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/academic functioning or usual social activities or relationships.

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