Obsessive-Compulsive and Related Disorders

Abstract

Obtaining an accurate diagnosis of an obsessive-compulsive and/or related disorder is complicated by many factors. These factors include (1) symptom overlap and high comorbidity with numerous other mental health diagnoses, (2) extremely diverse presentation of symptom content across individuals, (3) potential lack of insight of the individual into their symptoms and their role, and (4) potential for stigma or embarrassment surrounding certain thoughts and behaviors that commonly occur. These factors can prevent accurate reporting (for review, see Moulding, Hughes, Byrne, Do, & Nedeljkovic, 2016). Perhaps due to these diagnostic complications, there are many discrepancies in the literature regarding the prevalence and incidence of OCD (for review, see Fontenelle, Mendlowicz, & Versiani, 2006). An effective diagnostic interview is one in which the interviewer is capable of probing with specific questions to differentiate the form and function of symptoms, while also fostering an environment in which the individual feels safe to disclose symptoms that may be controversial or irrational in nature. Given that these disorders are often under-recognized or misdiagnosed, it is critical that clinicians are informed of the best assessment practices for specific purposes, settings, and individuals. This chapter provides an overview of the obsessive-compulsive and related disorders, recommendations for both formal and informal diagnostic interviewing and assessment, and tips for attaining the necessary information to make an accurate diagnosis. Additionally, we describe several cases as examples for how to engage in effective diagnostic interviewing with an array of symptom presentations