What kinds of questions would you ask a client during an assessment interview to find out whether he or she might have an obsessive disorder?

Although obsessive-compulsive disorder (OCD) is accepted as an illness with biological roots, it can't be diagnosed using a blood sample, X-ray, or other medical tests. A mental health professional such as a psychiatrist, psychologist, or family doctor or nurse with special training will usually make a diagnosis of OCD using their medical judgment and experience.

Many healthcare professionals use a tool called a structured clinical interview to see if your symptoms are consistent with OCD. Structured clinical interviews contain standardized questions to ensure that each patient is interviewed in the same way. These questions usually ask about the nature, severity, and duration of symptoms. You may also be asked about your mood or other symptoms to make sure there aren't other psychological problems that need to be addressed.

Although it can be embarrassing to reveal the details of your obsessions and compulsions, it will help the healthcare professional make the proper diagnosis and provide you with the best possible treatment.​

Do I Have OCD?

OCD is an anxiety disorder where you experience debilitating obsessions and/or compulsions.

Obsessions are thoughts, images, or ideas which won't go away, are unwanted, and which cause major distress. If you have OCD, it is common to have one or more obsessions linked to repeated doubts, a need for order, contamination by germs, or aggressive or disturbing ideas, as well as sexual and religious images.

Compulsions are behaviors that you feel you have to carry out over and over again to relieve your anxiety. If you have OCD, it is common to have compulsions, mental acts or rituals around cleaning, counting, checking, requesting or demanding reassurance, and ensuring order and symmetry.

However, just as feeling sad or blue on occasion is normal and does not mean that you have clinical depression, it is important to remember that having a strange thought or repeating something a couple of times does not necessarily mean that you have OCD.

Diagnosis

Only a mental health care professional like a psychiatrist, psychologist, or some family doctors should diagnosis a complex illness like OCD. Resources like websites, online chat rooms or message boards, or family members can be a great starting point. But they are no substitute for a one-on-one meeting with a trained healthcare professional.

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Health care professionals have several factors in mind when making a diagnosis of OCD. The obsessions and compulsions caused by OCD set off debilitating anxiety and are time-consuming.

If you have OCD, you will usually spend more than an hour a day thinking about your obsession, or carrying out your compulsion or ritual. For example, people with OCD often miss work or appointments because of compulsions.

Living With OCD

If you have OCD, the obsessions and/or compulsions aren't merely annoying. They cause major disruptions at work, school and in your relationships. If you have untreated OCD, it is often difficult to maintain a job, an intimate relationship, or even friendships.

OCD and Relationships

If you have OCD, you usually recognize the irrationality or excessiveness of your obsessions or compulsions. In contrast, people with other mental illnesses, like schizophrenia, often believe that their strange or unusual thoughts are perfectly normal.

Even though it can be easy to admit the irrationality of an obsession or compulsion in the safety of a professional's office, you may feel intense anxiety when experiencing your obsession (such as contamination with dirt), and you cannot carry out your compulsion (such folding laundry just the right way).

The symptoms of OCD often resemble other forms of mental illness, including generalized anxiety disorder, specific phobias, Tourette Syndrome, and hypochondria.

It is important to make sure that your symptoms are consistent with OCD and not another mental illness so that you get the kind of help you need.

By Owen Kelly, PhD
Owen Kelly, PhD, is a clinical psychologist, professor, and author in Ontario, ON, who specializes in anxiety and mood disorders.

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