connected in a realistic way with what
Obsessive-Compulsive and Related they are designed to neutralize or
Disorders prevent or are clearly excessive.
- Characterized by intrusive thoughts B. The obsessions or compulsions are
(obsessions) and repetitive behavior or time-consuming or cause clinically
mental acts (compulsions). significant distress or impairment in important
areas of functioning.
OBSESSION AND COMPULSION (OCD) C. Disturbance is not due to the direct physiological
effects of the substance.
Feature OBSESSION COMPULSION D. Disturbance is not better explained by the
symptoms of another mental disorder.
Definition Recurrent, unwanted, Repetitive behaviors or
and distressing mental acts performed to
thoughts, images, or reduce anxiety caused by Specify if:
urges. obsession. With good of fair insight: OCD believes are not true
Nature Intrusive and persistent; Intentional and repetitive; With poor insight: Believes OCD are probably true
causes anxiety or provides temporary relief With absent/delusional: Convinced that OCD beliefs
distress. from anxiety caused by are true
obsession.
Control Difficult to control or Feels necessary to Specify if:
ignore. perform, even if irrational. Tic-related: The individual has a current or past history
of tic disorder.
Four (4) Major Types of Obsessions
a. Symmetry Obsession (26.7%) OCD is also common for tic disorders, characterized
i. A preoccupation with order, exactness, by involuntary movements to cooccur in patients
or doing things in a specific manner. with OCD.
b. Forbidden Thoughts and Actions (21%)
i. Intrusive thoughts related to violence, Vocal tics (Tourette’s disorder): Involuntary
religious fears, or sexual ideas that go vocalizations (repeating words or phrases).
against one’s moral, beliefs, or values.
c. Cleaning and Contamination (15.9%) BODY DYSMORPHIC DISORDER (BDD)
i. Fear of germs, dirt, or contamination
- A mental disorder where individuals are
leading to excessive cleaning
preoccupied with perceived flaws in their
behaviors.
physical appearance, even if these flaws are
d. Hoarding (15.4%)
minor or unnoticable to others. It causes
i. Difficulty discarding possessions,
significant distress in their daily life.
regardless of their actual value, leading
- Some people think they are so ugly they
to excessive accumulation.
refuse to interact with others or otherwise
function normally for fear that people will
Diagnostic Criteria for Obsessive-Compulsive
laugh at their ugliness.
Disorder - Imagined ugliness
A. Presence of obsessions, compulsions, both:
Obsessions are defined by 1 and 2:
Diagnostic Criteria for Body Dysmorphic
1. Recurrent and persistent thoughts,
Disorder
urges, or images that are experienced,
A. Preoccupation with one or more defects or
Most individuals cause marked anxiety
flaws in physical appearance that is not
or distress.
observable or appears slight to others.
2. Individual attempts to ignore or
B. At some point, the individual has performed
suppress such thoughts to neutralize
repetitive behaviors (e.g. mirror checking,
them with some other thought or action.
excessive grooming) or mental acts in
Compulsions are defined by 1 and 2:
response (comparing their appearance to
1. Repetitive behaviors or mental acts
others) to the appearance concerns.
that the individual feels driven to
C. Causes clinically significant distress or
perform in response to an obsession.
impairment in social, occupational, or other
2. The behaviors or mental acts are aimed
important areas of functioning.
to prevent or reduce distress.
D. Not better explained by concerns with body
However, these behaviors are not
fat or weight in an individual whose symptoms
, meet diagnostic criteria for an eating disorder. hair loss.
B. Repeated attempts to decrease or stop hair
Specify if: pulling.
With good or fair insight: BDD beliefs are not true C. Causes significant distress or impairment in
With poor insight: BDD beliefs probably true social, occupational, or other important areas of
With absent insight: BDD beliefs are true functioning.
With muscle dysmorphia: Preoccupied with the idea D. Not attributable to another medical condition.
that his/her body build is too small or insufficiently E. Not better explained by symptoms of another
muscular. mental disorder.
HOARDING DISORDER EXCORIATION (SKIN-PICKING DISORDER)
- Characterized by persistent difficulty - Repetitive picking of the skin leading to skin
discarding or parting with possessions damage due to stress, anxiety, or boredom, and
regardless of their actual value. may feel guilt or shame afterwards.
- Excessive acquisition of things, difficulty
discarding anything, and living with Diagnostic Criteria for Trichotillomania
excessive clutter. (Hair-Pulling Disorder)
A. Recurrent skin picking resulting in skin lesions.
Diagnostic Criteria for Hoarding Disorder B. Repeated attempts to decrease or stop skin
A. Persistent difficulty discarding or parting with picking.
possessions, regardless of their actual value. C. Causes significant distress or impairment in
B. This difficulty is due to a perceived need to social, occupational, or other important areas of
save the items and to distress associated with functioning.
discarding them. D. Not attributable to another medical condition.
C. Results in accumulation of possessions that E. Not better explained by symptoms of another
congest and clutter active living areas. mental disorder.
Compromises their intended use.
D. Causes significant distress or impairment in
social, occupational, or other important
Mood Disorders
areas of functioning. - Characterized by prolonged periods of extreme
E. Not attributable to another medical condition. sadness (depression), elevated mood (mania
F. Not better explained by other symptoms of or hypomania), or mood fluctuations.
another mental disorder.
1. Depressive Disorders:
Specify if: a. Major Depressive Disorder
With excessive acquisition: Difficulty discarding b. Persistent Depressive Disorder
possessions is accompanied by excessive acquisition of (Dysthymia)
items that are not needed. c. Disruptive Mood Dysregulation Disorder
Specify if: d. Premenstrual Dysphoric Disorder
With good or fair insight: Recognizes that hoarding 2. Bipolar and Related Disorders:
beliefs and behaviors are problematic a. Bipolar I Disorder
With poor insight: Mostly convinced that hoarding b. Bipolar II Disorder
beliefs and behaviors are not problematic c. Cyclothymic Disorder
With absent insight: Convinced that hoarding beliefs
and behaviors are not problematic FUNDAMENTAL MOOD STATES IN MOOD
DISORDERS
TRICHOTILLOMANIA (HAIR-PULLING DISORDER)
- Repetitive pulling of hair in response to
DEPRESSION MANIA HYPOMANIA
stress, anxiety, or boredom, and even without
realizing they are doing it. Persistent low State if extreme Less severe form
- Can be hair from the scalp, eyebrows, mood, loss of elevated mood, of mania that does
interest, and high energy, and not cause severe
eyelashes, and other parts of the body. decreased energy impulsivity that impairment in daily
that severely severely disrupts functioning.
impacts daily life. functioning.
Diagnostic Criteria for Trichotillomania Duration: At least 4
(Hair-Pulling Disorder) Duration: At least 2 Duration: At least 1 days.
weeks week, or any
A. Recurrent pulling out of one’s hair, resulting in duration if
Obsessive-Compulsive and Related they are designed to neutralize or
Disorders prevent or are clearly excessive.
- Characterized by intrusive thoughts B. The obsessions or compulsions are
(obsessions) and repetitive behavior or time-consuming or cause clinically
mental acts (compulsions). significant distress or impairment in important
areas of functioning.
OBSESSION AND COMPULSION (OCD) C. Disturbance is not due to the direct physiological
effects of the substance.
Feature OBSESSION COMPULSION D. Disturbance is not better explained by the
symptoms of another mental disorder.
Definition Recurrent, unwanted, Repetitive behaviors or
and distressing mental acts performed to
thoughts, images, or reduce anxiety caused by Specify if:
urges. obsession. With good of fair insight: OCD believes are not true
Nature Intrusive and persistent; Intentional and repetitive; With poor insight: Believes OCD are probably true
causes anxiety or provides temporary relief With absent/delusional: Convinced that OCD beliefs
distress. from anxiety caused by are true
obsession.
Control Difficult to control or Feels necessary to Specify if:
ignore. perform, even if irrational. Tic-related: The individual has a current or past history
of tic disorder.
Four (4) Major Types of Obsessions
a. Symmetry Obsession (26.7%) OCD is also common for tic disorders, characterized
i. A preoccupation with order, exactness, by involuntary movements to cooccur in patients
or doing things in a specific manner. with OCD.
b. Forbidden Thoughts and Actions (21%)
i. Intrusive thoughts related to violence, Vocal tics (Tourette’s disorder): Involuntary
religious fears, or sexual ideas that go vocalizations (repeating words or phrases).
against one’s moral, beliefs, or values.
c. Cleaning and Contamination (15.9%) BODY DYSMORPHIC DISORDER (BDD)
i. Fear of germs, dirt, or contamination
- A mental disorder where individuals are
leading to excessive cleaning
preoccupied with perceived flaws in their
behaviors.
physical appearance, even if these flaws are
d. Hoarding (15.4%)
minor or unnoticable to others. It causes
i. Difficulty discarding possessions,
significant distress in their daily life.
regardless of their actual value, leading
- Some people think they are so ugly they
to excessive accumulation.
refuse to interact with others or otherwise
function normally for fear that people will
Diagnostic Criteria for Obsessive-Compulsive
laugh at their ugliness.
Disorder - Imagined ugliness
A. Presence of obsessions, compulsions, both:
Obsessions are defined by 1 and 2:
Diagnostic Criteria for Body Dysmorphic
1. Recurrent and persistent thoughts,
Disorder
urges, or images that are experienced,
A. Preoccupation with one or more defects or
Most individuals cause marked anxiety
flaws in physical appearance that is not
or distress.
observable or appears slight to others.
2. Individual attempts to ignore or
B. At some point, the individual has performed
suppress such thoughts to neutralize
repetitive behaviors (e.g. mirror checking,
them with some other thought or action.
excessive grooming) or mental acts in
Compulsions are defined by 1 and 2:
response (comparing their appearance to
1. Repetitive behaviors or mental acts
others) to the appearance concerns.
that the individual feels driven to
C. Causes clinically significant distress or
perform in response to an obsession.
impairment in social, occupational, or other
2. The behaviors or mental acts are aimed
important areas of functioning.
to prevent or reduce distress.
D. Not better explained by concerns with body
However, these behaviors are not
fat or weight in an individual whose symptoms
, meet diagnostic criteria for an eating disorder. hair loss.
B. Repeated attempts to decrease or stop hair
Specify if: pulling.
With good or fair insight: BDD beliefs are not true C. Causes significant distress or impairment in
With poor insight: BDD beliefs probably true social, occupational, or other important areas of
With absent insight: BDD beliefs are true functioning.
With muscle dysmorphia: Preoccupied with the idea D. Not attributable to another medical condition.
that his/her body build is too small or insufficiently E. Not better explained by symptoms of another
muscular. mental disorder.
HOARDING DISORDER EXCORIATION (SKIN-PICKING DISORDER)
- Characterized by persistent difficulty - Repetitive picking of the skin leading to skin
discarding or parting with possessions damage due to stress, anxiety, or boredom, and
regardless of their actual value. may feel guilt or shame afterwards.
- Excessive acquisition of things, difficulty
discarding anything, and living with Diagnostic Criteria for Trichotillomania
excessive clutter. (Hair-Pulling Disorder)
A. Recurrent skin picking resulting in skin lesions.
Diagnostic Criteria for Hoarding Disorder B. Repeated attempts to decrease or stop skin
A. Persistent difficulty discarding or parting with picking.
possessions, regardless of their actual value. C. Causes significant distress or impairment in
B. This difficulty is due to a perceived need to social, occupational, or other important areas of
save the items and to distress associated with functioning.
discarding them. D. Not attributable to another medical condition.
C. Results in accumulation of possessions that E. Not better explained by symptoms of another
congest and clutter active living areas. mental disorder.
Compromises their intended use.
D. Causes significant distress or impairment in
social, occupational, or other important
Mood Disorders
areas of functioning. - Characterized by prolonged periods of extreme
E. Not attributable to another medical condition. sadness (depression), elevated mood (mania
F. Not better explained by other symptoms of or hypomania), or mood fluctuations.
another mental disorder.
1. Depressive Disorders:
Specify if: a. Major Depressive Disorder
With excessive acquisition: Difficulty discarding b. Persistent Depressive Disorder
possessions is accompanied by excessive acquisition of (Dysthymia)
items that are not needed. c. Disruptive Mood Dysregulation Disorder
Specify if: d. Premenstrual Dysphoric Disorder
With good or fair insight: Recognizes that hoarding 2. Bipolar and Related Disorders:
beliefs and behaviors are problematic a. Bipolar I Disorder
With poor insight: Mostly convinced that hoarding b. Bipolar II Disorder
beliefs and behaviors are not problematic c. Cyclothymic Disorder
With absent insight: Convinced that hoarding beliefs
and behaviors are not problematic FUNDAMENTAL MOOD STATES IN MOOD
DISORDERS
TRICHOTILLOMANIA (HAIR-PULLING DISORDER)
- Repetitive pulling of hair in response to
DEPRESSION MANIA HYPOMANIA
stress, anxiety, or boredom, and even without
realizing they are doing it. Persistent low State if extreme Less severe form
- Can be hair from the scalp, eyebrows, mood, loss of elevated mood, of mania that does
interest, and high energy, and not cause severe
eyelashes, and other parts of the body. decreased energy impulsivity that impairment in daily
that severely severely disrupts functioning.
impacts daily life. functioning.
Diagnostic Criteria for Trichotillomania Duration: At least 4
(Hair-Pulling Disorder) Duration: At least 2 Duration: At least 1 days.
weeks week, or any
A. Recurrent pulling out of one’s hair, resulting in duration if
