differential diagnosis

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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

Last reviewed 01/2018

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