Obsessive-compulsive disorder (OCD) used to be categorised as an anxiety disorder. Not anymore. The latest edition of the DSM-5 (which was published in April 2014) sees OCD as a unique disorder quite different from generalised anxiety, specific phobias and panic disorder.
The new category in the DSM-5 is called ‘Obsessive-compulsive and related disorders’ (OCRD) and OCD is the main disorder from which this category was developed. It includes:
- Body dysmorphic disorder
- Hoarding disorder
- Hair pulling disorder (Trichotillomania)
- Excoriation (Skin picking) disorder
The reason these conditions have been grouped together is that they share key features of repetitive thoughts and/or behaviours that range from harm avoidance to pleasure seeking.
Body dysmorphic disorder and hoarding disorder share significant similarities to OCD and often co-exist with OCD. Like OCD, they frequently run in families and are triggered by similar psychobiological factors. From a clinical point of view, they respond in similar ways to treatment and share cognitive and mood factors.
Hair pulling disorder and skin picking disorder do not share as many factors with OCD. However, at this juncture they have been put in this classification in the DSM-5.
Personally, I resonate with this change in the classification of OCD. Having worked with patients suffering from anxiety for over thirty years, I found that OCD had different symptoms to anxiety and did not respond that well to classic CBT.
Anxiety, phobias and panic disorders manifest quite specific bodily reactions and research has shown that they all respond extremely well to Cognitive Behavioural Therapy.
The new category of OCRD reflects how research and clinical experience can inform and improve knowledge about conditions. It is important to stay abreast of the developments in order to provide, and receive, “best practice”, evidence based treatments.