A. The presences of obsessions, compulsions, or both.

B. The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. Not due to substance or medical condition.

D. No due to other mental disorder.

A. The presences of obsessions, compulsions, or both.

B. The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. Not due to substance or medical condition.

D. No due to other mental disorder.

With Good Insight

With Poor Insight

With Absent Insight/Delusional Belief (4% or fewer)

Tic-Related (30%)

U.S. 1.2% of population

Females have slightly higher rate.

Males have early age of onset and are more commonly affected in childhood.

Greater internalizing symptoms, higher negative emotionality, and behavioral inhibition are possible risk factors.

Childhood trauma including sexual and physical abuse are risk factors.

Various infectious agents and post-infectious autoimmune syndrome are risk factors.

76% have anxiety disorder,

63% have depressive or bipolar disorder,

23-32% have obsessive-compulsive personality disorder

A. Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight.

B. At some point during the course of the disorder, the individual has performed repetitive behaviors or mental acts in response to the appearance concerns.

C. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The appearance preoccupation is not better explained by concerns with body fat or weitht in an individual whose symptoms meet diagnostic criteria for an eating disorder.

With Muscle Dysmorphia

With good or fair insight

With poor insight (most likely)

With absent insight/delusional belief (33% or more)

Skin, hair, nose, or asymmetry.

Intrusive preoccupations consume 3-8 hours per day.

Comparing one's appearance,

checking perceived deficits in a mirror,

excessive grooming,

camouflaging,

seeking reassurance,

touching disliked areas to check them,

excessively exercising or weight lifting,

seeking cosmtice procedures, and

skin picking.

Executive function and visual processing abnormalities with a bias for analyzing and encoding details and missing holistic picture.

Also, a bias for negative and threatening interpretations of facial expressions and ambiguous scenarios.

U.S. 2.4%

Females slightly more likely than males.

Median age of onset 15.

Average age of onset 16-17.

Most common age of onset 12-13.

Subclinical concerns become the disorder over time.

A universal issue with some specific manifestations.

In Japan, Taijin kyosusho (avoidance of interpersonal situations) has a subtype (shubo-kyofu) that is similar to Body Dysmorphic Disorder.

Childhood neglect and abuse.

Having first-degree relatives with OCD.

Males more likely to have genital preoccupation.

Major depressive disorder

soical anxiety disorder

OCD

Substance-related disorder

A. Persistent difficulty parting with possessions regardless of their actual value.

B. The difficulty is due to perceived need to save the intems and to distress associated with discarding them.

C. The difficulty discarding rsults in the accumulation of possessions that congest and clutter active living areas and substantially compromises thier intended use.

D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

E. Not due to another medical condition (Prader-Willi).

F. Not better explained by another mental disorder.

With excessive acquisition (80-90%)

With good or fair insight

With poor insight

With absent insight/delusional beliefs

May be a special manifestation of hoarding disorder. Most who hoard animals also hoard inanimate objects.

Unsanitary conditions are a problem with animal hoarding.

Symptoms increase with age with first symptoms at ages 11-15 and most research subjects in their 50s.

Males have a significantly greater prevalence.

2-6% of people.

Stongly heretible (50% of variance).

Anxiety disorder 75% (especially GAD and social anxiety disorder.

OCD 20%.

A. Recurrent pulling out of one's hair resulting in hair loss.

B. Repeated attempts to decrease of stop hair pulling.

C. The hair pulling causes clinically significant distress or impairment.

D. The hair pulling or hair loss is not attributable to another medical condition.

E. The hair pulling is not better explained by aother mental disorder.

Hair pulling may be accompanied by a range of behaviors or rituals involving hair.

Hair pulling behavior may involve varying degrees of conscious awareness.

Many report an itch-like sensation that is alleviated by pulling hair.

Patterns of hair loss are highly variable.

1-2% of population

Females over males by 10:1 ratio

Most common onset is puberty

major depressive disorder and excoriation disorder most common.

Lip pulling, skin picking, and nail biting are common associated behaviors.

A. Recurrent skin picking resulting in skin lesions.

B. Repeated attempts to decrease or stop skin picking.

C. The skin picking causes clinically significant distress or impairment.

D. The skin picking is not attributable to another medical condition.

E. The skin picking is not better explained by another mental disorder.

1.4% with 3:1 ratio females to males.

Most common onset is puberty with chronic course.

More common when first-order relative has OCD.

Comorbid with major depressive disorder, OCD, and trichtillomania.

Substances: cocaine, amphetamine, other

With onset during intoxication

With onset during withdrawal

With onset after medication use

With obsessive-compulsive disorde-like symptoms

With appearance preoccupations

With hoarding symptoms

With hair-pulling symptoms

With skin-picking symptoms

Sydenham's chorea

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)