What are the key diagnostic criteria for Obsessive-Compulsive Disorder (OCD) according to NICE guidelines?

Key diagnostic criteria for Obsessive-Compulsive Disorder (OCD) according to NICE guidelines include:

• Presence of obsessions (recurrent, persistent, intrusive thoughts) and/or compulsions (repetitive behaviours or mental acts) that the person feels driven to perform in response to the obsessions.
• Recognition that these obsessions or compulsions are excessive or unreasonable, although this insight may vary.
• Symptoms cause marked distress, are time-consuming (e.g., take more than 1 hour per day), or significantly interfere with the person's normal routine, occupational or academic functioning, or usual social activities or relationships.
• Symptoms are not attributable to the physiological effects of a substance or another medical condition.
• Assessment should include exploration of the impact of compulsive behaviours on the individual and others, including distress and disability caused by symptoms.
• Healthcare professionals should sensitively explore hidden distress and disability, and inform patients that obsessive thoughts are common but become pathological when frequent and distressing.
• Risk assessment for self-harm and suicide is essential, especially if comorbid depression is present.
• Direct questions to identify OCD symptoms include: Do you wash or clean a lot? Do you check things a lot? Is there any thought that keeps bothering you that you would like to get rid of but cannot? Do your daily activities take a long time to finish? Are you concerned about putting things in a special order or very upset by mess? Do these problems trouble you?

These criteria and assessment approaches are embedded within NICE's guidance on recognition, assessment, and diagnosis of OCD in primary and secondary care settings, emphasizing the need for specialist involvement when diagnosis or risk is uncertain or complex ¹,².