Other Specified Obsessive-Compulsive and Related Disorders

Other specified Obsessive-Compulsive and Related Disorder is a category of DSM-5 diagnoses that applies to individuals who have symptoms characteristic of obsessive compulsive disorders (e.g. - obsessive compulsive disorder, body dysmorphic disorder) but do not meet the full criteria for any of them. This category in OCD also includes disorders with cultural components that have symptoms characteristic of OCD. “Other Specified” diagnoses are not limited to these disorders and are used throughout the DSM-5 to capture presentations where individuals have significant clinical impairment but do not meet standard criteria.^[1]

• This is similar to body dysmorphic disorder except that the defects or flaws in physical appearance are clearly observable by others (i.e. - they are more noticeable than “slight”). In such cases, the preoccupation with these flaws is clearly excessive and causes significant impairment or distress.

• Presentations that meet body dysmorphic disorder except that the individual has not performed repetitive behaviours or mental acts in response to the appearance concerns.

• This is characterized by recurrent body-focused repetitive behaviours (e.g. - nail biting, lip biting, cheek chewing) and repeated attempts to decrease or stop the behaviors. These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning and are not better explained by trichotillomania (hair-pulling disorder), excoriation (skin- picking) disorder, stereotypic movement disorder, or nonsuicidal self-injury.

• This is characterized by non-delusional preoccupation with a partner’s perceived infidelity. The preoccupations may lead to repetitive behaviors or mental acts in response to the infidelity concerns; they cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; and they are not better explained by another mental disorder such as delusional disorder (jealous type) or paranoid personality disorder.

• A variant of taijin kyofusho that is similar to body dysmorphic disorder and is characterized by excessive fear of having a bodily deformity.

• Related to dhat syndrome, koro is described in Southeast Asia (particularly Singapore), and is an episode of sudden and intense anxiety that the penis (or the vulva and nipples in females) will recede into the body, possibly leading to death. Also called shen-k'uei (“kidney deficiency”) in China. Related conditions in the DSM-5 include: major depressive disorder, persistent depressive disorder (dysthymia), generalized anxiety disorder, somatic symptom disorder, illness anxiety disorder, erectile disorder, early (premature) ejaculation, other specified or unspecified sexual dysfunction, or academic problems.

• A variant of taijin kyofusho (““interpersonal fear disorder”), jikoshu-kyofu is characterized by fear of having an offensive body odour (also termed olfactory reference syndrome). It is common in Japan and Korea.^[2] Individuals have a preoccupation with a belief of having foul/offensive body odour. There are repetitive behaviours in response to odour concerns (e.g. - washing, comparing to others). This can cause significant distress/impairment. Related conditions in the DSM-5 include: social anxiety disorder, body dysmorphic disorder, delusional disorder, obsessive-compulsive disorder.