Definition, Clinical Description, and Diagnosis | Clinical Features | Epidemiology | Comorbidity | Pathophysiology, Mechanisms, and Risk Factors | Course and Prognosis | Evaluation | Treatment | Research Directions | Summary Points | References
Obsessive-compulsive disorder (OCD) is characterized by the
presence of either obsessions (worries is
a more user-friendly term for children) or compulsions (rituals is
a more user-friendly term for children). Although OCD is categorized
among the anxiety disorders in DSM-IV (American Psychiatric Association 1994, 2000), especially in younger
children, a variety of hidden or poorly articulated affects may
drive the symptoms. There is active consideration of removing OCD
from the DSM category of anxiety disorders and creating a new limited
category for OCD "spectrum" disorders in DSM-V.
Table 23–1 shows the current DSM-IV-TR criteria for OCD.
The specifier "with poor insight" may be especially
relevant to the diagnosis in youth since children's ability
to explain their obsessions and the fears driving their compulsions
may be quite limited.