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Obsessional symptoms or compulsive acts or both must be present on most days for at least 2 successive weeks and be a source of distress or interference with activities. Either obsessions or compulsions (or both) are present on most days for a period of at least 2 weeks.
Table 3.13 DSM-IV to DSM-5 Obsessive-Compulsive Disorder Comparison. 1. Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress. 1.
Beginning with DSM-IV (APA, 1994), the diagnostic criteria for OCD included the specifier “with poor insight” to denote when a person did not (for most of the time while having the problem) recog-nize the senselessness of the obsessions or compulsions. Changes in DSM-5.
The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Corresponding update in DSM-5 Classification, Bipolar II Disorder (DSM-5, p. xvi; Desk Reference, p. xiv) As printed. As updated. Specify severity if full criteria for a mood episode are currently met: Mild, Moderate, Severe.
• Use DSM-IV-TR criteria for diagnosis. • Consider using screening questions to detect commonly unrecog-nized symptoms (Table 1). • Differentiate OCD obsessions, compulsions, and rituals from similar symptoms found in other disorders (Table 2). TABLE 1. Example Obsessive-Compulsive Disorder Screening Questions
The upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will in-clude a new chapter on Obsessive-Compulsive and Related Disorders to reflect the increasing evidence of these disorders’ relatedness to one another and distinction from other anxiety disorders, as well as