How is obsessive-compulsive disorder (OCD) diagnosed?

Unlike many conditions, obsessive compulsive disorder cannot be diagnosed with a blood test or scan. Wayne Goodman, MD, chairman of the Department of Psychiatry at the Mount Sinai School of Medicine, explains how trained specialist diagnose OCD.

1. Do you suffer from recurrent and persistent thoughts, impulses, or images that are disturbing, intrusive, and inappropriate, and which result in marked anxiety or distress?

2. Are these thoughts and worries more than just excessive worries about real life events or problems?

3. Do you attempt to ignore or suppress the thoughts, impulses, or images, or neutralize them with another thought or action?

4. Do you recognize that these events are coming from your own mind?

5. Do these obsessions cause marked distress, and take up more than one hour of your day, or interfere with your normal routine, or relationships, or work/school?

If you answered yes to these five questions, then you have OCD (obsessional type)

1. Do you have repetitive behaviors (such as germ avoidance, hand washing, ordering, checking, hoarding) or mental acts (counting, repeating words silently, praying compulsively) that you feel driven to perform?

2. Are these in response to an obsession, or certain rules that you have adopted which you feel must be applied?

3. Are these behaviors and mental acts designed to prevent or reduce distress or some dreaded event or situation, even though in reality there is no connection?

4. Do these obsessions cause marked distress, and take up more than one hour of your day, or interfere with your normal routine, or relationships, or work/school?If you answered yes to the above four questions, you have OCD (compulsive type).

David Tolin
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) notes that a diagnosis of OCD can be appropriate when the person experiences one or both of the following symptoms: Obsessions (intrusive thoughts, ideas, images, or impulses that are distressing) and Compulsions (repetitive behaviors that represent an attempt to prevent something bad from happening or alleviate the distress from obsessions). 

Diagnosing OCD also requires ruling out several other conditions whose symptoms can be similar to those of OCD. These can include (but are not limited to) autistic spectrum disorders, depression, other anxiety disorders, tic disorders, and psychotic disorders.  A thorough clinical history and structured diagnostic interview, administered by a trained professional, are the best strategy.  Other specialized assessment tools, such as the Yale-Brown Obsessive-Compulsive Scale, can also be helpful.

At this time, there is no physical way (e.g., brain scan, blood test) to diagnose OCD reliably, although many researchers are investigating this possibility.

Always consult your physician for a diagnosis. The disorder is diagnosed only when such activities:

  • consume at least one hour each day.
  • are very distressing.
  • interfere with daily life.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.