OCD Subtypes: Assessment Led Guidance

Specialist CBT therapy for anxiety, OCD, depression and more in West London

OCD can present in many different ways. Some people describe contamination fears, checking, symmetry or ordering, intrusive thoughts, relationship doubts or scrupulosity. A guide cannot diagnose OCD, determine which presentation applies to an individual or decide what support is appropriate. An assessment can consider the pattern, its impact, physical health, sleep, medication, other possible explanations and the person's goals. Presentations can overlap and change over time. A guide cannot determine whether a pattern of intrusive thoughts, compulsive responses or avoidance is clinically significant or whether it is OCD rather than another difficulty. An assessment can consider the full picture rather than assuming a single explanation. Intrusive thoughts can be distressing. Their content alone cannot diagnose OCD, establish a risk or tell a person what a thought means about them. A guide cannot decide whether a thought is part of an OCD pattern, a response to stress, a health concern, a crisis or something else requiring individual attention. If thoughts are accompanied by confusion, a sudden marked change in mental state, hallucinations, new neurological or physical symptoms, severe agitation, concern about acting on a thought, or difficulty staying safe, seek urgent appropriate help. In immediate danger, call 999 or attend A&E. CBT with an ERP component may be considered after individual assessment where OCD is affecting daily life. Exposure and response prevention should be planned with a suitably qualified clinician after discussion of the rationale, alternatives, safety and pacing. A guide is not a self directed ERP programme. For related information, see OCD therapy at https://lyceumclinic.co.uk/therapy/ocd/, the OCD comprehensive guide at https://lyceumclinic.co.uk/guides/ocd comprehensive guide/, OCD CBT tools at https://lyceumclinic.co.uk/guides/ocd cbt tools today/ and OCD ERP vs medication at https://lyceumclinic.co.uk/guides/ocd erp vs medication/. An enquiry can clarify whether CBT based support, medical review, urgent care or another source of help may be the relevant next step.