The DSM-5 notes the presence of disorders that are related to obsessive compulsive disorder. Similarly to obsessive compulsive disorder, obsessive-compulsive related disorders are characterized by someone having obsessions and compulsions that cause distress and impact their life. However the difference is that these disorders each have unique distinguishing factors that set them apart and create enough criteria for them to be their own subtypes.
These obsessive-compulsive related disorders include:
- Excoriation (skin picking) disorder: With skin picking disorders, the patient has strong urges to pick their skin they can’t ignore. They end up obsessively picking at their skin, sometimes for hours throughout the day. People with skin picking disorder might feel anxious or on edge before they pick, and then the picking provides feelings of pleasure and relief from anxiety. Sometimes, the picking is severe enough that it can cause scarring or tissue damage, which may even require medical attention and antibiotics. In many cases, skin picking disorder starts along with a dermatological condition like acne. It commonly co-occurs with anxiety and mood disorders.
- Trichotillomania (hair-pulling disorder): The behavior associated with trichotillomania is pulling hair out, whether it be from their head, eyebrows, eyelashes, or elsewhere. Within this disorder, there are two types of hair-pulling that have been identified: focused and automatic. Focused hair pulling is closer to an OCD compulsion, and the person is very aware that they’re doing it. On the other hand, automatic hair pulling is done more automatically or subconsciously without the person being fully aware that they’re doing it. Trichotillomania can result in hair loss, and the onset is usually in childhood or adolescence.
- Body dysmorphic disorder (BDD): When someone has body dysmorphic disorder, they obsess over what they perceive to be physical flaws, whether they be about their body, facial features, or skin. The flaws that they see are distorted, and they may not even be perceived by other people. This obsession with flaws is accompanied by related repetitive behaviors. For example, they may constantly examine themselves in the mirror or practice excessive grooming. The onset of BDD is typically in adolescence. Body dysmorphic disorder commonly occurs with major depressive disorder or social anxiety disorder.
- Hoarding disorder: People with hoarding disorder accumulate and keep an abnormal amount of items in their home. They have an intense need to keep all of their belongings, and they have an extremely difficult time parting with any of their belongings, which is why they have so much. This results in very cluttered living situations. Many people with hoarding disorder will continue to buy more and more items even though they know there is no space for them at their home. Typically, there are feelings of embarrassment and shame around hoarding, especially if other people see their home. The condition is chronic, usually starting in adolescence and continuing into adulthood.
- OCD-induced by a medication or due to another medical condition: In some cases, obsessive compulsive disorder may be caused by medications or substances. For example, some studies have reported that certain antipsychotics may induce obsessive compulsive disorder in some patients. Medical conditions can also cause obsessive compulsive disorder. One example of this is Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).
Another diagnosis to consider here is obsessive compulsive personality disorder. While it sounds very similar to obsessive compulsive disorder, there are clinical differences that set them apart from one another. It falls under the umbrella of personality disorders. People with obsessive compulsive personality disorder are extreme perfectionists and are fixated on doing everything their way, which is what they believe to be the only correct way. They may be preoccupied with lists, rules, and organization. Typically, they do not question themselves or feel ashamed of this obsession to do everything perfectly. Obsessive compulsive personality disorder can get in the way of relationships, especially in living situations.
Many people with obsessive compulsive disorder commonly also experience major depressive disorder (MDD). People living with either OCD or depression both experience anxious symptoms such as agitation, apprehension, and worry. Both of these conditions are also commonly treated by the same SSRI medications.
