Both DSM-IV(23) and ICD-10(24) define OCD, regardless of age, by obsessions and/or compulsions (criterion A), which are described, at some point during the course of the disorder, as excessive or unreasonable (criterion B), and are severe enough to cause marked distress or to interfere significantly with the person's normal routine, or usual social activities or relationships (criterion C). The specific content of the obsessions or compulsions cannot be restricted to another Axis I diagnosis, such as an eating disorder, a mood disorder, or schizophrenia (criterion D). DSM-IV adds that the disturbance is not due to the direct physiological effects of a substance or a general medical condition (criterion E).
ICD-10 allows subclassification of forms with predominant obsessions, predominant compulsions, or mixed symptoms. In DSM-IV, the only difference in diagnostic criteria between children and adults appears in criterion B; although most children and adolescents actually acknowledge the senselessness of their symptoms, the requirement that insight is preserved is waived for children.
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