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What Should the Diagnostic Criteria for Ocd Be?

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What should the diagnostic criteria for OCD be?

Definition of the disorder

Obsessive-compulsive disorder (OCD) has been classified as an anxiety disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) which people have idled and repeated thoughts, ideas and feelings that categorized as obsessions, or behaviours that make them feel driven to do something that categorized as compulsions or suffered both at the same times (Obsessive-compulsive disorder, 2014).

There are basically four major type of obsessions that associated with a pattern of compulsive disorder which are symmetry obsessions (26.7%), forbidden thoughts and actions (21%), cleaning and contamination (15.9%) and hoarding (15.4%) (Bloch, Landeros-Weisenberger, Rosario, Pittenger, & Leckman, 2008). Symmetry obsessions refer to a person that carry out the behaviours to keep the things in perfect order or doing something in specific way. Based on Bloch et al. (2008), the forbidden thoughts and actions refer to the fears to harm self or others and repeated requests for reassurance. Besides, cleaning and contamination refers to somebody that do repetitive or excessive actions to get rid of the “bacteria” that they think will harm themselves (Matthew, 2009). On the other hand, Hoarding means people keeps every clutter and piles up in their homes due to afraid that they may throw something important away (Barlow & Durand, 2014). The table 1.1 below shows the four different pattern of compulsive behaviours in the category of obsession and compulsion.

Table 1.1 Types of Obsessions and Associated





Need things to be symmetrical

Urges to do things over and over

Putting things in a certain order

Repeating rituals

Forbidden thoughts or actions

Fears, urges to harm self or others

Fears of offending God

Checking Avoidance

Repeated requests for reasurance


Fears of germs or contaminants

Repetitive or excessive washing

Use Gloves, masks to do daily tasks.


Fears of throwing anything away

Saving objects with no or little value. (Eg: Sugar wrapping paper)

OCD can comes with the eating disorders, anxiety disorders, or depression. This disorder also caused wasted of time for the patient who suffered in OCD. The person that suffered under OCD often do some behaviours to break away the obsessive thoughts in the mind but it usually provided only temporary reliefs (Obsessive-compulsive disorder, 2014).  In the statistical view, the chances for men and women to suffer in OCD are roughly in equal numbers (Barlow & Durand, 2014). Research also indicates that OCD might run in families. Based on Psychology today (2014), OCD symptoms typically begin during the teen years or early adulthood, but there are some children may even develop the illness during preschool.


        During European Renaissance, people used the time to examine past beliefs, for example, people will think that conditions such as mental illness were caused by devil or supernatural forces. As generation changed, this thought being replaced gradually by the naturalistic explanations (, 2009). During this ages, the world Obsession and Compulsion being named and categorized as “Scrupulosity. This term also being popularized by Jean Gerson and John Nider (Eduardo, 1961). The word “Scrupulosity” have meaning of obsessive religiosity in generation nowadays, but it bring meaning for all types of  Obsession and Compulsion disorders.

        In the early ages, clergy usually the groups that suffered more on OCD. It is because they need to deal with troubled parishioners most of the days. Thus, some of the English clergymen wrote down some advices on how to deals with OCD in late 1600s. For example, Richard Baxter wrote a book named “self-help” to give some suggestions like: seeking company of other people and keep oneself steadily occupied, for those patients who suffering in OCD (Clifford, 1716). As the changes of ages, clergymen’s role being challenged by some medical profession to take over the role of giving advice to treat OCD patients (, 2009).

        During 17th century, some physicians or doctor tried to treat Obsessions and Compulsions by using bloodletting (also called phlebotomy) to treat obsessive "bad" thoughts (Allen, 1683). This techniques also included draining blood from the patients in order to adjust the bodily “humours”. Besides, there was an astrological healer named Richard Napier (1559-1634) try to treat a woman's washing compulsion by positioning the symbols of the Sun, Moon, planets, determining her zodiac sign and so on (MacDonald, 1981).

In the 1800s, the mental illness became more common and  some of the physicians proved that OCD was not an insanity. It is not correct to put OCD sufferers in asylums in this century. This can be achieved due to some physicians make some effort to classify and categorize Obsessions and Compulsions and other mental illness (Esquirol, 1965).

Next, 19th century researchers have tried to identify Obsessions and Compulsions and mental illness in a better way, they gave many specific types of Obsessions and Compulsions their own names, for example, mysophobia (obsessive fear of contamination), délire du toucher (touching compulsions) and so on (Tuke, 1894). They also debated whether OCD should be categorized as  a form of insanity or not. For example, in Soren Kierkegaard (1848), the Danish philosopher, wrote brilliantly about obsessive "bad" thoughts.



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