*Still, in the most severe OCD cases, patients may lose such rational perspective on their illness and start thinking that their obsessions and compulsions make sense and are justified. *The presence of either obsessions or compulsions.
*The person recognizes that these obsessions or compulsions are excessive or unreasonable. *The obsessions or compulsions cause distress and disability, and take up more than an hour daily. *The obsessions or compulsions are not better explained by another mental illness (e.g., are not limited to preoccupations with weight in a patient who has anorexia nervosa). *The symptoms are not due to substance use or a medical condition. We all have our peculiar habits and bizarre superstitions, but most of us don’t suffer from OCD. Obsessive-compulsive disorder, the clinical condition, afflicts 1 to 2 percent of the population, and males and females are about equally likely to get it. For most sufferers, OCD is a chronic problem that will continue to negatively impact their lives, although the intensity of their symptoms may vary over time. The fourth edition of the Diagnostic and Statistical Manual, or DSM-IV, the “bible” used by mental health professionals for diagnosing mental illness, defines OCD as the presence of obsessions or compulsions. To be clinically meaningful and meet DSM-IV requirements for a psychiatric diagnosis, the obsessions or compulsions must take up at least one hour daily and interfere substantially in the person’s life. The DSM-IV criteria for diagnosing OCD are listed in on page 10. Typically, OCD includes both obsessions and compulsions.
Obsessions are unwanted thoughts, images, or impulses that come into the patient’s mind in a repetitive way and that the patient experiences as bothersome. Common obsessions in OCD include contamination fears, such as fear of catching an infection or fear of pollution; “pathological doubt,” especially about whether safety checks at home or in the car have been performed;...
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