Table 25 DSM-5 diagnosis of OCD

• Presence of either obsessions, compulsions, or both

○ Obsessions are defined by the following:

        • Recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted and that cause marked anxiety or distress

        • The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with other thoughts or actions

○ Compulsions are defined by the following:

        • Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rigid rules

        • Compulsions are aimed preventing or reducing anxiety or preventing some dreaded situation or event; however, they are not connected in a realistic way with what they are designed to neutralize or are clearly excessive

• The obsessions or compulsions are time-consuming (e.g., take >1 h/day) or cause clinically significant distress or functional impairment

• Specify patient’s degree of insight as to reality of OCD beliefs:

○ Good or fair insight (i.e., definitely or probably not true)

○ Poor insight (i.e., probably true)

○ Absent insight (i.e., completely convinced beliefs are true)

• Specify if "tic-related" OCD