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How to Diagnose Obsessive-Compulsive Disorder | Treatment & Assessment

Traditional TherapyObsessive-compulsive disorder, (OCD) is a mental health condition in which a person experiences uncontrollable, recurring thoughts, often about specific worries (obsessions), followed by performing specific behaviors to end the thoughts (compulsions). Generally, people who have OCD develop cycles in which they experience obsessive thoughts and are unable to stop themselves from their compulsive behavior.

Most people experience obsessive and uncontrollable thoughts or compulsive behaviors at some point in their lives; however, when these thoughts and behaviors begin to hinder a person’s life or lower their quality of life, they may have OCD.

People with obsessive-compulsive disorder may experience symptoms of obsessions, including:

  • Fear of contamination
  • Fanatical thoughts about sex, violence, or taboo subjects
  • Recurring thoughts of violent actions toward oneself or others
  • The need for everything to be symmetrical or in a specific order

These persistent worries may manifest in compulsive behaviors, such as:

  • Washing hands at specific times or a specific number of times
  • Repeatedly cleaning to get rid of a contamination
  • Counting a specific number of objects or making sure objects are still in place
  • A deep concern for grooming
  • Repeatedly checking the door, alarm, stove, oven, television, etc.

People with obsessive-compulsive disorder are unable to avoid their behavioral responses to obsessive thoughts. The development of rituals may occur but not everyone with a ritual or superstition has OCD. If thoughts and behaviors get in the way of enjoying life, going to work, performing family obligations, or other issues, it might be an indication of OCD.

Below are the steps are generally taken to diagnose OCD.

Step 1: Find a therapist.OCD symptoms can be psychologically painful, so it is important to find a therapist who works with people who have OCD and knows how to accurately diagnose this condition. It might be beneficial to get a second opinion to confirm the diagnosis and further understand the course of treatment. During the appointment, the therapist will try to rule out other mental health conditions, especially anxiety, which can manifest as obsessive thoughts. Other conditions to rule out include body dysmorphic disorder, hoarding disorder, or trichotillomania.

Step 2: Get a checkup with a physician.There may be a biological cause underlying the OCD symptoms. Getting a full physical, including bloodwork and even brain and body scans like x-rays, MRIs, or CAT scans, can determine if there is a physical condition that is affecting behavior and mood.
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Step 3: Take psychological exams.A therapist will likely apply at least one scale or test to determine the severity of OCD, as the condition can occur on a spectrum. This will help the therapist develop and refine an approach to treatment. One of the more popular tests for this is the Yale-Brown Obsessive-Compulsive Scale, although other diagnostic tests may be used to rule out depression, anxiety, PTSD, or other conditions. The psychologist will also likely use the DSM-5 to ensure their new client meets the criteria for OCD.

Step 4: Take prescription medications.Although therapy is the best treatment for OCD, medications will also likely be prescribed to alleviate obsessive thoughts and control compulsive behaviors. These may be antidepressants like Prozac or Zoloft, or they could be antipsychotic medications like Risperdal or Abilify. The specific medication prescribed depends on the range and severity of OCD.

If the medications do not work as expected, this could be an indication to the psychologist that they must refine their diagnosis or that symptoms of obsessive-compulsive disorder have a different root cause, requiring a different course of treatment.