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Diagnostic Changes
Obsessive-Compulsive and Related Disorders The chapter on obsessive-compulsive and related disorders, which is new in DSM-5, reflects the increasing evidence that these disorders are related to one another in terms of a range of diagnostic validators, as well as the clinical utility of grouping these disorders in the same chapter. New disorders include hoarding disorder, excoriation (skin-picking) disorder, substance-/medication-induced obsessive-compulsive and related disorder, and obsessive-compulsive and related disorder due to another medical condition. The DSM-IV diagnosis of trichotillomania is now termed trichotillomania (hair-pulling disorder) and has been moved from a DSM-IV classification of impulse-control disorders not elsewhere classified to obsessive-compulsive and related disorders in DSM-5.

Specifiers for Obsessive-Compulsive and Related Disorders
The “with poor insight” specifier for obsessive-compulsive disorder has been refined in DSM-5 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 beliefs are true). Analogous “insight” specifiers have been included for body dysmorphic disorder and hoarding disorder. These specifiers are intended to improve differential diagnosis by emphasizing that individuals with these two disorders may present with a range of insight into their disorder-related beliefs, including absent insight/delusional symptoms. This change also emphasizes that the presence of absent insight/delusional beliefs warrants a diagnosis of the relevant obsessive-compulsive or related disorder, rather than a schizophrenia spectrum and other psychotic disorder. The “tic-related” specifier for obsessive-compulsive disorder reflects a growing literature on the diagnostic validity and clinical utility of identifying individuals with a current or past comorbid tic disorder, because this comorbidity may have important clinical implications.

Demographic Information
This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of Obsessive-Compulsive Disorder that they are likely to see in their clinical practice.

{| class="wikitable sortable" border="1" ! Setting (Reference) ! Base Rate ! Demography ! Diagnostic Method

(Ruscio et al., 2010) sample (n=2073) International Diagnostic Interview (CIDI 3.0)
 * National Comorbidity Survey Replication
 * 2.3%
 * National (U.S.) adult
 * World Health Organization Composite

(Karno et al., 1988) (n=18572)
 * Epidemiological Catchment Area (ECA) Program
 * 1.9-3.3%
 * U.S. household sample
 * Diagnostic Interview Schedule (DIS)

Mohammadi et al., 2004 (n=25180)
 * Iranian population-based study
 * 1.8%
 * Iranian adults
 * DIS

(Himle et al., 2008) (n=5191)
 * African-American and Caribbean Households (U.S.)
 * 1.6%
 * NSAL Adult Study
 * CIDI Short Form

(Subramaniam et al., 2012) (n=6616)
 * Singapore Mental Health Study
 * 3.0%
 * Epidemiological sample
 * CIDI 3.0