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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

It is important to distinguish obsessive compulsive disorder (OCD) from other psychiatric disorders in which obsessive symptoms are present.

The important differentials are:

  • primary depressive disorder:
    • depressed patients may present with obsessional symptoms
    • as many as 30% of severe depressives develop obsessional symptoms
    • diagnosis is complicated because the course of OCD is often punctuated with periods of depression

  • schizophrenia:
    • patients may present with obsessional symptoms
    • schizophrenia should be suspected if the thoughts or rituals are particularly bizarre

  • Tourette's syndrome:
    • the incidence of OCD in families with Tourette's syndrome is increased

  • organic psychiatric syndromes:
    • these are rare, an example is encephalitis lethargica

  • anankastic personality disorder

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