The chapter “Obsessive-Compulsive and Related Disorders” is new in DSM-5.
New disordersinclude hoarding disorder, excoriation (skin-picking) disorder, substance/medication-induced obsessive-compulsive and related disorder, and obsessive-compulsive andrelated disorder due to another medical condition
. The DSM-IV diagnosis of trichotillomaniais now termed trichotillomania (hair-pulling disorder) and has been moved from a DSM-IV classification of impulse-control disorders not elsewhere classified to obsessivecompulsive and related disorders in DSM-5.
The DSM-IV “with poor insight” specifier for obsessive-compulsive disorder has been refined to allow a distinction between individuals with good or fair insight, poor insight, and “absent insight/delusional” obsessive-compulsive disorder beliefs (i.e., complete conviction that obsessive-compulsive disorder beliefsare true).
Analogous “insight” specifiers have been included for body dysmorphic disorder and hoarding disorder.
A “tic-related” specifier for obsessive-compulsive disorder has also been added, because presence of a comorbid tic disorder may have important clinical implications.
A “muscle dysmorphia” specifier for body dysmorphic disorder is added to reflect a growing literature on the diagnostic validity and clinical utility of making this distinction in individuals with body dysmorphic disorder.
The delusional variant of body dysmorphic disorder (which identifies individuals who are completely convinced that their perceived defects or flaws are truly abnormal appearing) is no longer coded as both delusional disorder, somatic type, and body dysmorphic disorder; in DSM-5, this presentation is designated only as body dysmorphic disorder with the absent insight/delusional specifier.
Individuals can also be diagnosed with other specified obsessive-compulsive and related disorder, which can include conditions such as body-focused repetitive behavior disorder and obsessional jealousy, or unspecified obsessive-compulsive and related disorder.