How Obsessive-Compulsive Disorder (OCD) Is Diagnosed

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Obsessive-compulsive disorder (OCD)—a psychiatric disorder characterized by obsessive, distressful thoughts and compulsive, ritualistic behaviors—can be diagnosed by either a primary care provider or mental health professional.

Like most mental health conditions, there is no blood test or imaging study to confirm a diagnosis. However, after decades of research into many mental health illnesses, mental health professionals have acquired a lot of information to accurately diagnose and treat conditions.

An anxious senior woman sitting outdoors on a park bench while rubbing her index finger.

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At-Home Testing

In general, it's not possible—or reasonable—to self-diagnose. However, some online quizzes might offer you insight into the symptoms associated with OCD and help you evaluate whether your symptoms may lead to a diagnosis.

The current gold standard for helping diagnose OCD by way of a questionnaire is one called the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)

The Y-BOCS asks about:

  • The interference and distress obsessive thoughts and compulsions cause in your life
  • Your level of control over obsessions and compulsions

You can find a version of this questionnaire online from the International Obsessive Compulsive Disorder Foundation.

If you have an appointment scheduled with a healthcare provider, it may be beneficial to print out the questionnaire, answer the questions, and bring it to your appointment.

While the Y-BOCS questionnaire is the gold standard, it is also quite in-depth and lengthy and can seem overwhelming.

If you're looking for a more straightforward online quiz, you might consider the one found on PsychCentral. The PsychCentral questions focus more on symptoms and less on severity levels. Be aware that while this quiz may indicate the possibility that you have OCD, it does not cover your OCD symptoms' severity.

Please remember both these tools are simply that—tools. Only a trained medical professional can give you an official diagnosis and offer you treatment options.

Professional Screenings

There are many ways you can go about seeking help and relief from obsessive thoughts and compulsive behaviors. Most people will start with a visit to their primary care provider. Others may choose to go directly to a psychologist or other mental health professional. Neither way is wrong. 

Prescribing Physicians

It's important to note that while psychologists and therapists who are not medical doctors (MDs) are an excellent resource for those with OCD, they cannot prescribe medications. If you think you might benefit from prescription medication, consider starting your treatment by seeing a primary care doctor or psychiatrist.

When you see your primary care provider or mental health professional, they will often ask why you think you may have OCD. They'll be interested in learning what behaviors are causing you concern at this time.

Some questions you can expect your doctor to ask—or that you might fill out on a questionnaire—include:

  • How long have these behaviors been going on?
  • Do you have these thoughts or perform these behaviors all the time or only on occasion?
  • Is there anything you avoid because you are self-conscious of your behavior or because the thoughts associated with it are distressing?
  • On an average day, how much time do you spend thinking about or acting on your specific symptoms?
  • Is there anything that makes your symptoms worse?

Diagnostic Testing

While there is no specific blood test doctors use to check for OCD, your doctor may order lab work to rule out any underlying medical issues that may be contributing to your symptoms or that may interfere with treatment.

Many times doctors will want to check for thyroid function and metabolic function, and also order a complete blood count (CBC)

Consider a Differential Diagnosis

OCD can be difficult to diagnose, and your provider will go through all the possible options that can present similarly to OCD. Diagnoses that might overlap include:

  • Other anxiety disorders
  • Tic disorder or Tourette's syndrome
  • Mood disorders
  • Psychotic disorders
  • Eating disorders

Each of these disorders has its own criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—the book all mental health professionals use as a guide for diagnosing conditions.

The good thing to remember is these diagnoses are treatable. They can be challenging to live with, but specialists have learned a lot about OCD and all other mental health conditions over the last few decades and are there to help.

There now are multiple ways to treat each condition. If one method isn't working for you, let your provider know until you find the right treatment option.

A Word From VeryWell

While living with OCD can be stressful, seeking help can be equally or more stressful for many people, especially those who are afraid of being judged, ignored, or under- or overtreated.

Fortunately, mental health professionals are focused on helping people through arduous and overwhelming times. They are trained to not judge or shame people, which is just one reason you shouldn't be afraid to hide alarming thoughts from them. They have the tools and resources to help. 

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Article Sources
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  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: 2013. doi:10.1176/appi.books.9780890425596

  2. National Institute of Mental Health. Obsessive-compulsive disorder. Updated October 2019.

  3. International OCD Foundation. How is OCD diagnosed?