5 Diagnostic Updates to Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is one of the most common mental disorders in the United States. Studies have shown that 2 in every 50 adults have experienced bouts of OCD in their lifetime, and 33 percent of those people believe their disorder began in childhood. Left untreated or misdiagnosed, this condition is extremely difficult to live with.
OCD creates severe anxiety in those suffering from it. Intrusive and obsessive thoughts drive repetitive behaviors in an effort to relieve fear and worry. The symptoms that people living with OCD suffer from vary from individual to individual, and from one extreme to another.
What are some of the Symptoms of OCD?
- Excessive cleanliness or washing
- An aversion to particular numbers
- Relationship based symptoms, such as continuous doubts that their partner loves them or constant worry about whether they’re in the “right” relationship
- Nervous rituals, like turning locks or opening and closing a door a particular number of times before being able to move on
- A preoccupation with sexual, violent or religious thoughts and images
The result of these obsessive and compulsive behaviors can cripple a person in their day-to-day life, as well as alienate them in their personal and professional lives.
The American Psychiatric Association (APA) revised the OCD criteria for OCD in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5 is the diagnostic tool of record for mental health professionals around the world, and this latest edition represents the most significant changes to the manual in nearly twenty years.
What are the DSM-5 updates for Obsessive-Compulsive Disorder?
1. OCD now has its own chapter in the DSM-5 called Obsessive-Compulsive and Related Disorders. Previously, OCD was listed under anxiety disorders in the manual. Some experts have disagreed with this move due to the tendency of anxiety disorders and OCD to exist at the same time. This is referred to as a co-occurring disorder. They further argue that both disorders respond to similar methods of treatment.
However, another survey reveals that approximately 60 percent of mental healthcare professionals agree with the change. This group believed that since the main factors of OCD are obsession and compulsion, not anxiety, the disorder should have it’s own category.
2. DSM-5 removes the requirement that individuals must be aware that their obsessions and compulsions are excessive or unreasonable in order for a diagnosis of OCD. Previously, patients had to understand and acknowledge obsessive behaviors before an official OCD diagnosis could be made.
3. Two disorders that weren’t previously listed under OCD have been moved to the chapter. The first is trichotillomania, which is a hair pulling disorder. The second, body dysmorphic disorder, is a condition where patients obsess over an imagined or actual flaw in their appearance. Generally, the flaw is nonexistent.
4. Both hoarding and excoriation, skin picking, were previously listed only as symptoms of OCD. However, these two conditions are now considered obsessive-compulsive disorders on their own in the DSM-5.
5. Due to language concerns and how the meanings of certain words differ between cultures, ages and genders, DSM-5 updates some words. For instance, the word “inappropriate,” in reference to describing obsessions was replaced with the word “unwanted.” The word “impulse” was changed to “urge” in order to better define an obsession.
Treatment for OCD and Co-occurring Substance Abuse Disorder
It is common for those who suffer from OCD to feel shame about their condition. As a result, many people with this disorder withdraw, attempt to hide the symptoms, and sometimes, self-medicate with drugs and alcohol. The Journal of Anxiety found that 25 percent of patients seeking treatment for OCD also met the requirements for substance abuse disorder.
Once properly diagnosed, though, the right medications can be administered to help alleviate symptoms. Patients can also benefit from behavioral and cognitive therapies in addition to medication. Addressing dependency issues is important, in order to further bring the brain’s chemistry into balance.
Many people who learn to cope with OCD and substance abuse issues go on to lead normal, happy lives after getting the care, attention and the treatment these conditions demand.
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