TABLE 2. Symptoms of Other Psychiatric Disorders to be Differentiated From the Obsessions, Compulsions, and Rituals of Obsessive-Compulsive Disorder (OCD)
How the Symptom Differs From Symptoms of OCD
The content of the delusions is usually related to grandiosity.
Body dysmorphic disorder
Recurrent and intrusive preoccupation with a perceived bodily defect
The preoccupation is limited to the body.
Unlike OCD obsessions, depressive ruminations are experienced as consistent with one's self-image and usually concern self-criticism, failures, guilt, regret, or pessimism about the future. Unlike obsessions, depressive ruminations do not lead to compulsive rituals.
Intrusive thoughts and unhealthy behaviors regarding weight and eating
The thoughts and behaviors are limited to weight and eating.
Generalized anxiety disorder
Unlike with OCD, worry does not lead to compulsive rituals.
Fear or belief regarding serious disease
In OCD, such fear arises from an external stimuli (e.g., that causes contamination) rather than misinterpretation of an ordinary bodily sign or symptom.
Obsessive-compulsive personality disorder (OCPD)
Hoarding, scrupulosity, perfectionism, preoccupation with rules and order
In OCD, obsessions and compulsions usually focus on specific feared events; in OCPD, thoughts and behaviors are globally colored by traits such as perfectionism and preoccupation with rules.
Intrusive sexual thoughts and urges
OCD obsessions are resisted, are morally abhorrent to the individual, and lead to avoidance.
Urges to harm an infant
OCD thoughts and urges do not emerge from depressed mood or psychosis and are resisted.
Posttraumatic stress disorder
Intrusive thoughts and images
The thoughts replay actual events rather than anticipate future events as in OCD.
The content is usually bizarre or related to persecution, grandiosity, passivity experiences, or ideas of reference.
Complex vocal or motor tics
Tics, unlike compulsions, are not preceded by thoughts nor aimed at relieving anxiety or preventing or undoing an event.