Why was OCD Removed from Anxiety Disorders? DSM 5

Why was OCD Removed from Anxiety Disorders: DSM 5

Obsessive-compulsive disorder (OCD) is a common, chronic anxiety obsessive-compulsive disorder (OCD) is a brain disorder characterized by intrusive and repeated thoughts that lead to compulsive behaviors. But, why was OCD removed from anxiety disorders?

In 2013, the DSM classification of anxiety disorders by the American Psychiatric Association removed OCD from the list of anxiety disorders to become a separate diagnosis. The reasons were that there are significant differences in the brain function and chemistry that occurs for OCD and anxiety disorders. However, there are similarities in some symptoms and treatments but they may also vary or be contradictory.

OCD varies in severity and affects 2-3 percent of the general population. People with OCD are “obsessed” with certain thoughts, feelings, or behaviors. Let’s go deeper into why OCD was removed from anxiety disorders as per the DSM V.


Why was OCD removed from anxiety disorders?

In 2013, the DSM classification of anxiety disorders by the American Psychiatric Association removed OCD from the list of anxiety disorders to become a separate diagnosis. The reasons were that there are significant differences in the brain function and chemistry that occurs for OCD and anxiety disorders. However, there are similarities in some symptoms and treatments but they may also vary or be contradictory.

Both OCD and anxiety disorders fall under the bigger umbrella category as per ICD-10 of “neurotic, stress-related, and somatoform disorders. Therefore, the two distinct conditions share familial and genetic factors but present differently and may be treated differently depending on the individual.

The reasons why the divide was supported were OCD is a result of obsessions and compulsions, rather than anxiety which causes anxiety disorders. Therefore, there has been a tendency currently to de-emphasize its anxiety-driven character and focus on the obsessions and compulsions in the diagnosis and treatment.

Should OCD be classified as an anxiety disorder in DSM V?

In 2013, DSM-5 separated OCD from anxiety disorders. This was done by creating a distinct category of Obsessive-Compulsive and Related Disorders. OCD is a chronic, long-term condition that often lasts for years and can be life-altering.

In the DSM-5, obsessive-compulsive disorder (OCD) is classified as a separate category of disorder, distinct from anxiety disorders. However, it is important to note that OCD can often co-occur with anxiety disorders, and there are similarities in the symptoms experienced by individuals with OCD and those with anxiety disorders.

OCD is characterized by recurrent, intrusive thoughts or obsessions, as well as repetitive behaviors or compulsions that are performed in response to these obsessions. These obsessions and compulsions are time-consuming and can significantly interfere with daily functioning and relationships.

While anxiety is a common feature of OCD, the disorder is considered separate because it involves unique features such as the presence of obsessions and compulsions, and the inability to resist performing the compulsive behaviors. Additionally, OCD responds differently to treatment than most anxiety disorders, with the most effective treatment being a form of cognitive-behavioral therapy known as exposure and response prevention.

Ultimately, the decision to classify OCD as an anxiety disorder would depend on how one defines and conceptualizes anxiety and its relationship to OCD. While there are arguments to be made for both classifying OCD as an anxiety disorder and keeping it as a separate category, the current classification in the DSM-5 reflects the consensus of experts in the field.

It’s not just about having obsessions or compulsions you can’t control. And it’s not just about the harm OCD can cause to your mental health or quality of life. The problem with OCD is that it always rears its ugly head when you need it least and never when you need it most. We know from research that people with OCD are more likely to have other disorders, like depression and anxiety, which makes things even more complicated.

Why was OCD Removed from Anxiety Disorders: DSM 5

But we also know that OCD is primarily a biological disorder rooted in differences in brain chemistry, which means medication alone isn’t enough treatment.

When was OCD removed from anxiety disorders?

OCD was first classified as an anxiety disorder in the DSM-III, which was published in 1980. However, in the DSM-IV, which was published in 1994, OCD was given its own category separate from anxiety disorders. This decision was based on accumulating evidence that suggested that OCD had distinct features and responded differently to treatment than other anxiety disorders.

The DSM-5, published in 2013, continued to classify OCD as a separate disorder but included it in a new category called “Obsessive-Compulsive and Related Disorders.” This category also includes disorders such as body dysmorphic disorder, hoarding disorder, and trichotillomania (hair-pulling disorder), which share some features with OCD. The decision to create this category was based on research that suggested these disorders had unique clinical features and treatment needs that differed from other disorders.

So to answer your question, OCD was removed from the category of anxiety disorders in the DSM-IV, which was published in 1994.

There are many misconceptions about the condition, such as it being related to “cleanliness” or in some cases that it is attention-seeking behavior. However, this is not true and those who have OCD often feel shame, guilt, and embarrassment about the disorder.

OCD can be characterized by two types of thoughts: obsessions and compulsions. Obsessions are intrusive thoughts that cause distress; they may include worries about dirt or germs, fears of violence, or concerns with sexuality or religion.

Compulsions are repetitive behaviors that someone feels they must do in order to reduce the distress caused by the obsession. These compulsive behaviors may include hand washing, checking something repeatedly (e.g., locks), or counting things in sequences.

Symptoms of OCD

There are several symptoms of OCD. All of them are obsessive and exhibit extreme fear. They include:

  • Fear of contamination or dirt.
  • Compulsive hoarding
  • Doubting and having difficulty tolerating uncertainty
  • Needing things orderly and symmetrical
  • Ritualistic behavior
  • Aggressive or horrific thoughts about losing control and harming yourself or others
  • Unwanted thoughts, including aggression, sexual, religious subjects, and agitation
  • Apprehension, guilt, or panic attack
  • Meaningless repetition of own words and actions

For example, a person with OCD may experience persistent and irrational fear of germs and contamination, resulting in repeated hand washing and cleaning. Or, a person with OCD may experience extreme distress if they are not able to do things in a particular order or fashion.

These behaviors can become so routine that people with OCD may have trouble functioning outside of their “spaces” or rituals. That’s where the OCD comes in. Many common fears and anxieties can lead to obsessive-compulsive behavior.

For example, someone who is afraid of heights may be afraid of falling and that fear may lead them to repeatedly check for ladders or windows in the area. Someone who is afraid of the contamination may notice things that are out of place or unclean, and that fear may lead them to repeatedly wash their hands.

Or, someone who is afraid of losing control may be afraid of what other people will think of them and that fear may lead them to repeatedly check to see if they are still wearing the same clothes or if they are saying the same things they said before.

Or, someone who is afraid of hurting someone else may be afraid of hurting themself and that fear may lead them to repeatedly check for injuries.

When do OCD symptoms start?

OCD can start at different ages where in some it presents in childhood but for others, it may start even in old age. We have noted in our clinic some kids present with OCD. However, in most cases, people first develop OCD symptoms in two ranges of years: Between ages 10 and 12 (childhood- early teenage years) and between the late teens (around 18 years) and early adulthood (around 25 years).

In most cases that we have treated, the condition started during adolescence. The peak diagnosis period is 19 years. However, it may start later during early adulthood or earlier during childhood gradually.

However, in some cases, OCD can start abruptly. OCD is more likely to develop if you have a close family member with OCD. Having anxiety, depression, and substance abuse disorders are also linked to the development of OCD.

OCD triggers

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There are several triggers for OCD, including anything that causes stress, anxiety, and especially a feeling of lack of control. There are many possible causes of OCD.

Genetic factors and some medical conditions can increase your risk for developing OCD, but it’s not a certainty. Other potential causes include: – Chemical imbalances in the brain

  • Brain injuries
  • Brain infections (such as herpes)
  • Anxiety disorders
  • Brain inflammation
  • Stressful life events, like the death of a loved one or financial difficulties.

OCD can be triggered by anything that causes stress, anxiety, and especially a feeling of lack of control. There are also some medical causes and genetic factors. OCD is common among people who have experienced stressful life events or trauma.

For example, survivors of sexual abuse may experience recurring thoughts about what had happened to them. The more someone experiences these traumatic thoughts without relief, the higher the likelihood they will develop an obsessive fear related to those thoughts and behaviors related to their fears.

OCD Causes

The exact cause of OCD is unclear. It’s likely that a combination of factors, such as genes and environment, may contribute to the disorder.

OCD usually begins with a specific problem, such as an obsessive fear of germs or contamination, But it can also start without any trigger.

OCD is more common in females than males, About 1.2 percent of females and 0.4 percent of males have OCD at some point in their lives, the disorder usually starts in the teens or early adulthood, but it can begin later on for some people, Researchers don’t know what causes OCD but genetics, brain abnormalities, and environmental factors may play a role.

OCD is more common in females than males. Studies show that about 1% of all females will develop OCD at some point in their life compared to 0.5% of males who will develop the disorder at some point in their life.

There are three main types of obsessions:

  • Obsession with one idea or thought (obsessions)
  • Repeated thoughts about having committed a terrible act (scary thoughts)
  • Repetitive actions that seem necessary to prevent something bad from happening (rituals)

Who is most likely to get OCD?

OCD can affect people of all ages. However, the peak period for OCD diagnosis is 19 years. However, what are the causes of OCD, and who is most likely to get it? OCD is not caused by stress. It is a disorder of the brain and not just a reaction to stress. Some people are more at risk for developing OCD than others.

Some risk factors that make someone more likely to develop OCD include:

  • Family history of mental health issues or obsessive-compulsive disorder
  • Abnormalities in certain physical parts of the brain, like a smaller hippocampus or an enlarged caudate nucleus
  • History of childhood trauma
  • Personality traits such as perfectionism, having high moral standards, and being afraid of change
  • Being female

Diagnosing OCD

There is no approved test for OCD. Therefore, when you visit a medical expert to conduct a diagnosis, they refer to the symptoms and then use DSM V to deduce the disorder.

The criteria explained in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) are thus used to diagnose OCD. For example, you might tell your healthcare provider that you’re afraid to touch doorknobs because they might have germs on them and your thoughts are telling you that if you don’t wash your hands after touching a doorknob, you’ll get sick and die.

OCD treatment

You can treat OCD with either a combination of psychotherapy or medications or one of them. Often, treatment is most effective with a combination of these two approaches. OCD is a condition that cannot be cured, but it can be treated.

Treatment typically includes psychotherapy and medications, often in conjunction with one another. Therapy or medication may not fully cure you of OCD, but they can help relieve obsessions and compulsions so that you can function more normally in your everyday life.

There are four types of therapy used in the treatment of OCD:

  • Cognitive Behavioral Therapy (CBT)
  • Exposure and Response Prevention (ERP)
  • Habit Reversal Training (HRT), and Acceptance
  • Commitment Therapy (ACT).

Cognitive Behavioral Therapy teaches you to understand your thoughts as just thoughts and not facts, which in turn helps reduce the compulsions you experience.

Exposure therapy helps people confront their fears by gradually increasing their exposure to the thing they’re afraid of, such as dirt or germs, until it’s no longer distressing.

Finally, ACT focuses on being present for your feelings instead of trying to avoid them or mitigate them with compulsive behaviors. These different therapies work together to combat OCD symptoms.

Medications work differently depending on which type you’re taking: Serotonin reuptake inhibitors affect serotonin levels in the brain which are low in those who suffer from OCD; Selective serotonin reuptake inhibitors affect serotonin levels too; Tetracyclics affect norepinephrine levels; Tricyclics affect dopamine levels; Monoamine oxidase inhibitors are rarely prescribed anymore because they have many side effects like weight gain and high blood

Effectiveness of OCD Treatment

Studies have shown that a combination of medication and psychotherapy is effective in treating OCD. A type of psychotherapy called cognitive-behavioral therapy (CBT) can help you learn how to control your mental processes and how to break the obsessive cycle.

The goal of CBT is to change the way people react to their thoughts, feelings, and situations so they don’t feel anxious or threatened. It helps people identify negative thoughts and behaviors, then teaches them alternative behaviors.

The most common types of CBT are:

  • Exposure Response Prevention
  • Cognitive Restructuring
  • Habit Reversal Training.

It’s been hypothesized that OCD could be caused by an imbalance in neurotransmitters in the brain – such as serotonin or dopamine. But others believe it could be a result of a dysfunctional immune system or some kind of social stress factor.

What can happen if OCD is not treated?

If you don’t get treated if you have OCD, you can develop other severe mental health conditions including depression, anxiety, and panic attacks. OCD can also lead to other damaging behaviors, such as substance abuse.

Substance abuse is common in people with cope with the distress emanating from untreated mental disorders such as OCD. This is because it is a way to try and cope with the symptoms and fears associated with OCD.

When you live with untreated OCD, you will have a marked reduction in the quality of life. This can take its toll on your mental (emotional) and physical well-being. In most people, obsessive thoughts make it very difficult and even impossible to work, school, or even take care of the family.

Therefore, untreated OCD can lead to the following among others:

  • Academic failure;
  • Depression
  • Emotional exhaustion;
  • Isolation;
  • Loss of focus at work or school;
  • Loss of sleep;
  • Panic attacks
  • Physical exhaustion.

At the extreme end, people with untreated OCD may even become completely incapacitated, housebound, and even suicidal. This is because some fears make it hard to even get out of your home.

OCD was removed from the DSM because it was determined that the disorder was better classified as a type of anxiety disorder.

Does OCD go away with age?

OCD is a disorder that can affect people of all ages, but it usually starts in the late teens or early twenties. Studies have shown that the disorder is more common in boys than girls, but this may be because girls are less prone to seek help.

OCD symptoms will not go away throughout your life, but they will change and lessen over time. You might eventually be classified as having chronic OCD.

Is OCD a Brain Disorder?

Is OCD a Brain Disorder?

OCD is a brain disorder whose cause is incorrect information processing. People suffering from OCD who visited our clinic claimed that their brains became stuck on a certain compulsion, urge, or thought.

This can happen in a number of ways.

  • Obsessions are thoughts you can’t stop thinking about and which you feel the urge to do something about, even if it makes no sense to you.
  • Compulsions are behaviors you have to do over and over, again and again, because you think they’ll help relieve your anxiety or make your obsessions go away.
  • If a person has obsessive thoughts that cause them to avoid going outside because they might get contaminated by germs, their compulsion might be hand washing or wearing gloves all the time. OCD is not caused by a lack of moral strength, intelligence, religious beliefs, or any other factor within the individual’s control.

Can anxiety be mistaken for OCD?

Some people may confuse anxiety disorders including separation anxiety disorder and agoraphobia with OCD. In fact, researchers estimate that up to a third of people with OCD also have an anxiety disorder.

This can make it difficult for people to recognize that they have OCD or the severity of their symptoms. In order to diagnose someone with OCD, the person must experience obsessions and compulsions on a regular basis for at least one year.

It’s also important that obsessive thoughts and compulsive behaviors cause distress or interfere with life. What is going to happen if I do not seek treatment?

Types of OCD

The four types of OCD that stand out are:

  • Cleaning/contamination OCD
  • Order/symmetry or counting compulsions OCD
  • Harm OCD,
  • Hoarding OCD

These four types of OCD are very different from one another but all have their own specific set of triggers and causes for their respective disorder.

Do I have OCD or just anxiety?

Someone who has anxiety might also experience obsessions, but they typically don’t get as much control over their thoughts. Until the DSM-5 in 2013, OCD was classified as an anxiety disorder. That means that people with OCD were diagnosed with both OCD and another anxiety disorder.

But it’s not always clear if someone has an anxiety disorder or just OCD because it can be hard to tell what is causing the obsessive thoughts and compulsive behaviors.

So, in 2013, OCD was removed from the list of anxiety disorders and put into its own category. The medical name for the condition is now obsessive-compulsive disorder (OCD).

The Bottom Line

OCD is a complex mental health disorder. In some cases, it has genetic roots, but in many others, it’s triggered by emotional trauma or stress. OCD can be hard to live with, and those with the condition may not know what causes it.

Thankfully, treatments for this disorder do exist, and they work if you stick with them. The Bottom Line Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by disturbing thoughts that lead to compulsive behaviors.

OCD can be challenging to live with and without knowing what causes it, so treatment is important. Medications and therapy are effective in treating OCD and symptoms of co-occurring disorders such as depression or substance abuse.

OCD is a difficult and complex disorder. Lots of people have symptoms or false beliefs that mimic the symptoms of OCD. But the key difference is that these people don’t have an obsession that causes them to feel anxious, distressed, or out of control.

The bottom line is that OCD is not caused by bad parenting, childhood abuse, or some personality flaw. It’s a biologically based brain disorder with increasing evidence for a genetic contribution as well. The symptoms are also not imaginary – they can be real and intense for those who suffer from it.


What is OCD?

The cause of OCD is not known, but some experts believe it could be a combination of genetic and environmental factors.

What is the DSM?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published in 1952 by the American Psychiatric Association to serve as a guide for diagnosing mental disorders. In 2013, OCD was removed from the DSM.

How many people have OCD?

More than 2 million Americans have been diagnosed with OCD. The true number is probably higher because not all go get diagnosed or seek treatment.

Is OCD curable?

There is no cure for obsessive-compulsive disorder (OCD), but it can be treated with a variety of therapies and medications, which can help reduce symptoms.

Dr. David Barlow

David is a well-known researcher and author in the anxiety disorders area with extensive research on their etiology, nature, and treatment. He started the site to share his real-life experiences on the management of anxiety disorders with successful diagnosis and treatment being his motivation to write or review the content on this site.