Obsessive-Compulsive and Related Disorders: Introduction
Conditions which fall within the category of Obsessive-Compulsive and Related Disorders all share some key features of obsessions and compulsions. Obsessions are recurrent, persistent and intrusive anxiety provoking thoughts or images resulting in subsequent repetitive behaviors referred to as compulsions. Obsessions may include thoughts, feelings, ideas and sensations that compel a person to do specific behaviors or compulsions. Some of the more common obsessions include excessive counting, ruminating about physical flaws, hoarding and picking at one’s skin. Some of the resulting rituals which are common among individuals diagnosed with obsessive-compulsive disorder frequently include recurrent handwashing, frequently checking doors and locks and avoidance of specific situations. For an individual to be considered for a diagnosis of obsessive-compulsive disorder it must be disruptive to their daily existence and functioning. Disorders listed in this category all share the common feature of excessive preoccupation along with the subsequent engagement in repetitive behaviors.
Changes from the DSM-4 TR to the DSM-5:
There were significant changes from previous editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Obsessive-compulsive disorder was previously classified in the DSM-4 TR as an anxiety disorder. The new DSM-5 has created a standalone chapter separate from the other anxiety disorders. This also follows revisions within the ICD 10 CM which also classifies OCD separately from anxiety disorders. However, there should never be any confusion as to the close relationship between obsessive-compulsive disorders and anxiety disorders. When the separation of obsessive-compulsive disorder from anxiety disorders was anticipated prior to the publication of the new DSM-5, psychiatrists supported the move significantly more often than other mental health clinicians, with only 40% to 45% of other mental health professionals supporting the move to the new category. Many psychologists, counselors and other mental health professionals did not support the change because of the fact that most treatment protocols for obsessive-compulsive disorder are also similar for anxiety and other related disorders. As is the case with most anxiety related disorders and depression, comorbidity is frequently the rule rather than the exception.