Should OCD be Removed from Anxiety Disorders in the DSM-V?

Obsessive-compulsive-disorder (OCD) is currently listed under anxiety disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, the upcoming revised edition of the DSM proposes removing OCD from this category and listing it under the heading of related OCD conditions, which include body dysmorphic disorder (BDD), tic disorders, eating disorders, alcohol and drug dependence, trichotillomania, obsessive-compulsive personality disorder (OCPD), and other impulse disorders, such as kleptomania. This is of great concern to many mental health experts who believe that OCD is a genetically inherent in individuals with a family history of anxiety. To provide further evidence of this, O. J. Bienvenu of the Department of Psychiatry and Behavioral Sciences at John Hopkins University School of Medicine in Maryland conducted a study that examined the comorbidity and genetic relationship between many of these conditions, OCD, and anxiety.

For the study, Bienvenu gathered data from two existing OCD research projects, the John Hopkins OCD Family Study (JHOFS) and the OCD Collaborate Genetics Study (OCD). The two studies provided family history and comorbidity on more than 450 individuals over a period of 10 years. After reviewing the data, Bienvenu discovered that anxiety, personality, depressive or obsessive-compulsive disorders were more likely to be present in participants who had OCD or had an immediate family member with OCD. Specifically, the findings revealed that generalized anxiety, agoraphobia, OCPD, tic disorders, BDD, and grooming disorders were comorbid in most of the participants with a family or personal history of OCD. However, eating disorders, impulse control issues, and alcohol or drug dependence were not common in this group of participants. Bienvenu believes the evidence from this study underscores the concerns raised by mental health professionals with regard to the upcoming DSM-5. Bienvenu added, “Since anxiety disorders are highly comorbid with OCD, and they appear to share familial influences with OCD, we feel it would be erroneous to remove OCD from the anxiety disorders section in DSM-5.”

Bienvenu, O. J., Samuels, J. F., Wuyek, L. A., Liang, K.-Y., Grados, M. A., Cullen, B. A.,  Riddle, M. A., Greenberg, B. D., Rasmussen, S. A., Fyer, A. J., Pinto, A., Rauch, S. L., Pauls, D. L., McCracken, T. J., Piacentini, J., Murphy, D. L., Knowles, J. A., Nestadt, G. Is Obsessive-Compulsive Disorder an Anxiety Disorder, and What, If Any, Are Spectrum Conditions? A Family Study Perspective. Psychological Medicine 42.1 (2012): 1-13. Print.

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  • Michelle

    February 16th, 2012 at 5:18 AM

    What good would it be to remove something like OCD that affects so many people from the major diagnosis and coding manual that most physicians use? Are we now saying that this is not a valid disorder that merits its own diagnosis? I think not.

  • Nick

    February 16th, 2012 at 12:38 PM

    From the perspective of one who has ocd, I fail to understand why members of the medical community would wish to remove ocd from the list of anxiety disorders. OCD is Anxiety at its worst! By removing ocd from the anxiety disorders listing and clumping it with other spectrums that on the outside appear to be similar but are extremely different on the inside is absurd! and to include impulse control disorders with it is idiotic! people with ocd are the least likely to be kleptomaniacs and are extremely unlikely to be extremely impulsive. we can be somewhat impulsive just like regular people but extreme impulse issues are not the forte of ocd. quite the opposite in fact.

    In my opinion more research needs to be done on ocd and other anxiety related disorders. it sounds like there are many “experts” who are not experts at all. truly learn what ocd is before you make an idiotic suggestion to reclassify it into something it so is not.

  • nate

    February 16th, 2012 at 1:10 PM

    whichever category it belongs to,if the treatments are okay and improved then that is what will matter in the end.

  • Maura

    February 16th, 2012 at 2:37 PM

    I agree with Nate. Moving categories does not mean that it will no longer be recognized. It is just that maybe this is a better fit for a header than the other categories where it may have once fallen. No matter what it is not like someone who is familiar with OCD is going to fail to treat it just because the description is on a different page. Where there would be some concern though and what providers have to think about is maybe how recategorizing could affect insurance coverage and how payment for the services will be rendered.

  • Russell F

    February 17th, 2012 at 9:43 AM

    There r many ways to describe n classify a could fit the properties of two different groups or may be unlike any other.and if it is d former then there really is no right way of cud b treated on a case to case basis.

  • ace

    February 20th, 2012 at 7:56 AM

    Is this just one more step towards some trying to prove that this is not something that should be considered disordered behavior at all? If so then shame on them, because if you have known someone personally with ocd then you know that this is something that can shut down a life.

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