Obsessive-Compulsive Spectrum Disorders

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There are a number of disorders that don't technically meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for obsessive-compulsive disorder (OCD). However, they have very similar symptoms.

The DSM-5 has a whole chapter dedicated to these similar disorders entitled "Obsessive-Compulsive Related Disorders," also known as obsessive-compulsive spectrum disorders. The obsessive-compulsive spectrum includes different clusters of symptoms that are similar to, but not exactly the same as, OCD symptoms.

Often (but not always) the only difference between OCD and a given obsessive-compulsive spectrum disorder is the specific focus of the obsessions and/or compulsions.

Here are the disorders the DSM-5 includes in the chapter regarding obsessive-compulsive related disorders.

Body Dysmorphic Disorder

Body dysmorphic disorder is a form of mental illness in which the person is obsessed and/or preoccupied with an imagined defect or what they perceive as something abnormal in their appearance. It has to sufficiently impair the person's quality of life or cause extreme distress in order to be diagnosed. It is similar to OCD because both illnesses involve repetitive checking.

Skin Picking (Excoriation Disorder)

Pathologic skin picking, also called excoriation disorder, is one of several disorders classified as body-focused repetitive behaviors (BFRBs). It's a mental illness in which the person compulsively picks or digs into the skin with fingers, pins, tweezers, or other items to remove small irregularities such as moles or freckles.

Although classified as an impulse control disorder, skin picking is similar to OCD in that people with both illnesses engage in repetitive behaviors, usually because they feel uncomfortable. 

Trichotillomania

Trichotillomania (TTM) is another BRFB in which the affected person repeatedly pulls out hair from any part of the body for non-cosmetic reasons, resulting in noticeable hair loss. Like skin picking and other BRFBs, TTM is similar to OCD in its repetitive behaviors.

Hoarding Disorder

Pathological or compulsive hoarding is a specific type of behavior characterized by symptoms including:

  • Acquiring and failing to throw out a large number of items that would appear to have little or no value to others.
  • Severe cluttering of the person’s home so that it is no longer able to function as a viable living space.
  • Significant distress or impairment of work or social life.

While hoarding is no longer considered a subtype of OCD, it has similar characteristics, such as spending a large amount of time collecting, arranging, and putting items in order.

The chief difference between hoarding and OCD is that individuals that are affected by hoarding often don't have insight into how serious their disorder really is.

Effective Treatment Requires an Accurate Diagnosis

Just like any illness, it's extremely important that you are being treated for the right disorder. Treatments may vary depending on which disorder you are diagnosed with.

Being diagnosed incorrectly can waste valuable time, money, energy and even prolong your suffering. If you think you may have a different disorder than the one you have been diagnosed with, be sure to talk to your physician. 

Sources
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  • http://www.adaa.org/understanding-anxiety/DSM-5-changes
  • http://www.ucdmc.ucdavis.edu/psychiatry/calendar/DSM5_presentation_20130830.pdf
  • https://iocdf.org/about-ocd/related-disorders/

By Owen Kelly, PhD
Owen Kelly, PhD, is a clinical psychologist, professor, and author in Ontario, ON, who specializes in anxiety and mood disorders.