Obsessive-Compulsive and Related Disorders
1. Overview & Epidemiology
DSM-5-TR carved Obsessive-Compulsive and Related Disorders out of the old "anxiety neuroses" into a stand-alone chapter. Members: OCD, body dysmorphic disorder (BDD), hoarding disorder, trichotillomania (hair-pulling), excoriation (skin-picking), plus substance/medication-induced and secondary-to-medical-condition forms. ICD-10 (used at Debrecen) still files OCD under F42 within neurotic/stress-related disorders; ICD-11 has now created its own OCD-related grouping mirroring DSM-5.
The unifying thread: intrusive, repetitive thoughts/urges and repetitive behaviours done to neutralise them. Contrast this with anxiety disorders (cued/uncued fear) and impulse-control disorders (failure to resist an urge that is pleasurable at the moment of acting).
| Disorder | Lifetime prevalence | Typical onset | Sex |
|---|---|---|---|
| OCD | ~1–2% | Mean ~19–20 yr; bimodal (childhood/teens + early adulthood) | Roughly equal; earlier onset in males |
| Body dysmorphic disorder | ~1–2% | Mid-adolescence | Slight female excess |
| Hoarding disorder | ~2–5% | Begins in teens, worsens with age, clinical by 30s–50s | Slight male excess (clinical) |
| Trichotillomania | ~1–2% | Early adolescence | Female ≫ male (~10:1 in clinics) |
| Excoriation (skin-picking) | ~1–2% | Adolescence | Predominantly female |
- PANDAS / PANS — Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection: abrupt-onset OCD and/or tics in a child after group-A β-haemolytic streptococcal infection (anti-basal-ganglia antibodies). A high-yield "what causes sudden childhood OCD?" examiner trap.
- Impulse-control disorders (kleptomania, pyromania, intermittent explosive disorder; pathological gambling = now "gambling disorder"). DSM-5 moved pathological gambling out of impulse-control disorders into Substance-Related and Addictive Disorders (the first recognised behavioural addiction), and moved trichotillomania into the OCD-related chapter. Pyromania and kleptomania remain in "Disruptive, Impulse-Control and Conduct Disorders."
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