What should be included in a psychiatric review of systems and comorbidities in the evaluation of obsessive-compulsive disorder (OCD)?

Updated: May 17, 2018
  • Author: William M Greenberg, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Individuals with OCD frequently have other psychiatric comorbid disorders, prominently including major depressive disorder, alcohol and/or substance use disorders, other anxiety disorders, impulse control disorders (eg, trichotillomania, skin-picking), and Tourette and tic disorders. (Perhaps 40% of individuals with Tourette disorder will have OCD). Therefore, in taking a psychiatric history, the focus should be on identifying such comorbidities, seeking to elicit the following:

  • Mood and anxiety symptoms

  • Somatoform disorders, especially hypochondriasis and body dysmorphic disorder

  • Eating disorders

  • Impulse control disorders, especially kleptomania and trichotillomania

  • ADHD

Childhood-onset OCD may have a higher rate of comorbidity with Tourette disorder and ADHD.


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