Tests and diagnosis

By Mayo Clinic Staff

To help diagnose OCD, your doctor or mental health provider may do exams and tests, including:

  • Physical exam. This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications.
  • Lab tests. These may include, for example, a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
  • Psychological evaluation. A doctor or mental health provider asks about your thoughts, feelings, symptoms and behavior patterns. Your doctor may also want to talk to your family or friends, with your permission.

Diagnostic criteria for OCD

To be diagnosed with OCD, you must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health professionals to diagnose mental illnesses and by insurance companies to reimburse for treatment.

General criteria required for a diagnosis of OCD include:

  • You must have either obsessions or compulsions or both.
  • You may or may not realize that your obsessions and compulsions are excessive or unreasonable.
  • Obsessions and compulsions are significantly time-consuming and interfere with your daily routine and social or work functioning.

Your obsessions must meet these criteria:

  • Recurrent, persistent and unwelcome thoughts, impulses or images are intrusive and cause distress.
  • You try to ignore these thoughts, images or impulses or to suppress them with compulsive behaviors.

Compulsions must meet these criteria:

  • Repetitive behavior that you feel driven to perform, such as hand-washing, or repetitive mental acts, such as counting silently.
  • You try to neutralize obsessions with another thought or action.
  • These behaviors or mental acts are meant to prevent or reduce distress, but they are excessive or not realistically related to the problem they're intended to fix.

Diagnostic challenges

It's sometimes difficult to diagnose OCD because symptoms can be similar to those of obsessive-compulsive personality disorder, anxiety disorders, depression, schizophrenia or other mental illnesses. Someone with true obsessions and compulsions has OCD, although it's possible to have both OCD and obsessive-compulsive personality disorder. Be sure to stick with the diagnostic process so you can get appropriate diagnosis and treatment.

Aug. 09, 2013