| < Prev | Next > |
|---|
The DSM-IV criteria require that the following criteria for obsessions be met:
recurrent, persistent thoughts, impulses or images that are intrusive and inappropriate and that cause marked anxiety or distress;
these thoughts, impulses or images are not simply excessive worries about real-life problems;
the patient attempts to ignore or suppress the thoughts, impulses or images or to neutralize them with another thought or action;
the patient recognizes that the obsessions are a product of his or her own mind (and not imposed from outside). The DSM-IV criteria require that the following criteria for compulsions be met:
they must be repetitive behaviors or mental acts that the patient feels driven to do in response to an obsession or according to rules that must be rigidly applied;
these behaviors or mental acts are aimed at preventing or reducing distress or at preventing some feared event; however, they must not be connected in a realistic way with what they are designed to prevent or they must be clearly excessive.
The ICD-10 criteria differ in that obsessions are defined as thoughts, ideas or images and compulsions are defined as acts. By contrast, the DSM-IV criteria above distinguish between obsessions on the basis of whether the thought, idea or image causes anxiety (an obsession) or whether it is designed to relieve the anxiety (a compulsion, which may therefore be an act or a thought).
Symptoms and signs
Up to one-third of patients have only covert compulsive rituals, and some claim only to have obsessions. Compulsions without obsessions are uncommon but not rare.
Most patients have multiple obsessions and compulsions, and there is a tendency for them to shift with time. In the majority of patients, the severity of obsessive-compulsive disorder symptoms tend to wax and wane over time; adolescence and the post-partum period are often accompanied by exacerbation.
Individual obsessions and compulsions are very common in the general population but to qualify as having obsessive-compulsive disorder, a patient must have symptoms that are severe enough to interfere with function or to cause notable distress.
(from PsychiatryMatters.MD)
