How Obsessive-Compulsive Disorder (OCD) Is Diagnosed

No blood test or imaging study can diagnose obsessive-compulsive disorder (OCD). While there are online assessments and checklists for OCD symptoms, you should not use these tools to try to diagnose yourself. Only a healthcare provider (like your primary care provider) or a mental health professional can determine if you have OCD.

This article will cover how OCD is diagnosed and what to expect from OCD screening. It will also cover the assessments and medical tests providers can use to determine if your symptoms are best explained by OCD or another condition.

At-Home OCD Testing

You should not try to self-diagnose OCD. Only a qualified and licensed mental health professional can diagnose you with OCD. Online self-assessments for OCD can offer some insight into your thoughts, feelings, and behaviors, but they are not meant to diagnose you with OCD or any other mental health condition.

While you can see many of these assessments online, they’re not meant to be used to diagnose yourself with OCD.

If you have an appointment scheduled to be assessed for OCD, you can look through the documents before you see your provider. The assessments may help you organize your thoughts and describe what you’re feeling during your appointment.

Professional Screenings

A healthcare provider will start by talking to you about your general health and mental well-being. They will also want to know your family history, including any medical or mental health conditions that run in your family. They will also ask about any medications or supplements you are taking and if you use any substances.

A provider will inquire as to why you think you have OCD. They can use a structured interview (a set of prepared, closed-ended questions requiring a yes/no answer) or a freeform approach (a guided conversation with open-ended questions) to talk with you about your feelings and behaviors and see if they match up with the criteria for diagnosing OCD or another condition.

Some questions you can expect to be asked during an OCD assessment include:

• How long have these thoughts and behaviors been going on?
• How frequently do you experience these thoughts or behaviors?
• Are these thoughts distressing to you?
• Have you tried to stop the thoughts? If so, what have you tried, and have any of these steps worked?
• Do you have specific behaviors that you must do in response to your thoughts? Do these actions or behaviors make sense to you?
• Do you worry about what will happen if you do not act on the urge to do the behaviors in response to your thoughts?
• Have you tried to suppress the urge to do these behaviors? Have you been able to do so?
• Do you feel self-conscious about your behavior? Do you avoid anything (like social situations) because you are embarrassed by your behavior?
• On an average day, how much time do you spend thinking about your symptoms? How much time do you spend on the behaviors associated with them?
• Is there anything that makes your symptoms worse? Does anything make them better?
• How well are you able to function in your daily life? Do your symptoms affect your life at school or work?
• Have your symptoms and behaviors affected your relationships?

Your appointment length will depend on your symptoms, general health, and how your provider chooses to screen you. Plan to spend around 60 to 90 minutes in their office.

Diagnostic Criteria for OCD

To meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for OCD, a person must:

• Have recurrent, unwanted, and intrusive thoughts (obsessions) that are distressing and cannot be suppressed or ignored
• Feel driven to perform behaviors or rituals (compulsions) that are meant to relieve the fear, anxiety, and/or distress associated with obsessions

The obsessions and compulsions must cause a person significant distress and impairment in their ability to function in daily life (such as in school, at work, or in their relationships).

Consider a Differential Diagnosis

Providers also need to rule out other mental health or developmental disorders that could be causing your symptoms before diagnosing you with OCD. Conditions that can share symptoms with OCD include:

• Anxiety disorders
• Tic disorder or Tourette’s syndrome
• Mood disorders
• Psychotic disorders
• Eating disorders
• Phobia
• Autism spectrum disorder (ASD)
• Body dysmorphic disorder
• Hoarding disorder
• Trichotillomania
• Dementia and other neurodegenerative diseases
• PANDAS (in children)

These disorders have their own diagnostic criteria in the DSM-5. If your provider thinks one of the conditions could be a better explanation for your symptoms than OCD, they will talk to you about the next steps in working toward a diagnosis.

Summary

There is no single test for OCD, but providers have tools like the criteria in the DSM-5 and specific assessments that help them screen people for the condition.

You should not try to self-diagnose yourself with OCD. If you’re having symptoms that are troubling you, reach out to a healthcare provider. They may want to do blood tests or other medical tests to rule out another cause for your symptoms before referring you to a mental health provider to talk about an OCD diagnosis.