OCD Diagnosis?

[JosieLouise]

Hi there. So I've had an official diagnosis of Hypochondriasis for over 6 years now, but have only recently done some research into the apparent link between health anxiety and OCD. I can see so many simarlarities in the thought processes and behaviours I get, but I don't think I have any other OCD symptoms like you might expect. So I guess my question is... Anyone been diagnosed with OCD as a direct result of their health anxiety?

I know it sounds awful, but I genuinely feel like people would take me more seriously if I could tell them my behaviour is down to OCD and not have to explain away the stigma of a hypochondriac.

I'm not self diagnosing or looking for diagnosis here... Just discussion :)

[swgrl09]

Hypochondriasis has a lot of similarities to OCD and is characterized in the same group. Actually in the DSM V it isn't even called hypochondriasis anymore. It has been changed to illness anxiety disorder as one option or somatic symptom disorder as another option. Mayo Clinic describes both as:

"To meet the criteria for somatic symptom disorder, patients must have one or more chronic somatic symptoms about which they are excessively concerned, preoccupied or fearful. These fears and behaviors cause significant distress and dysfunction, and although patients may make frequent use of health care services, they are rarely reassured and often feel their medical care has been inadequate.

Patients with illness anxiety disorder may or may not have a medical condition but have heightened bodily sensations, are intensely anxious about the possibility of an undiagnosed illness, or devote excessive time and energy to health concerns, often obsessively researching them. Like people with somatic symptom disorder, they are not easily reassured. Illness anxiety disorder can cause considerable distress and life disruption, even at moderate levels."

It's the same with other types of obsessive compulsive disorders. DSM V also includes hoarding disorder as a separate diagnosis, when it used to be part of OCD. So really it is just a way of categorizing/labeling symptoms. But they all share traits.

[MyNameIsTerry]

Swgrl, I thought Illness Anxiety Disorder was one form of those available within the Somatic Symptom Disorder group?

We use the WHO manual over here, not the DSM, for diagnosis so I'll add that side as there are differences.

We have no OCD Spectrum Disorders group, hence OCD sits on it's own. As does GAD, both of which are under the umbrella term of HA. Hypochondriasis doesn't exist in the WHO manual anymore, but there is a Somatoform Disorder group (they don't make it easy for us all, do they? :doh:).

All of the above sit within "Neurotic, stress-related and somatoform disorders" group. Within this GAD sits within sub group "Other anxiety disorders" whereas OCD sits within subgroup "Obsessive-compulsive disorder". Then you have those Somatoforms I mentioned that sit within subgroup "Somatoform disorders".

There are a number of Somatoform Disorders but really only a few of them are well explained and others are mop ups to catch what falls outside of the main ones.

If you want to have a read of the criterias, I can link you to the manual.

We also have to remember that Health Anxiety is not a medical term. You won't find it anywhere in the WHO manual. Hypochondriasis. was replaced with "Hypochondriacal disorder" in the move from the old ICD-9 version to the ICD-10 that is currently in use. Quite oddly, this disorder also includes Body Dysmorphic Disorder which no longer appears on it's own (I think that's in your OCD Spectrum Disorders group, swgrl). Hypochondriacal disorder is only one of the Somatoform Disorders, but it's one of the main ones.

OCD is OCD in this manual, but it is split into 5 disorders. They are nothing to do with themes (e.g. the hoarding mentioned above) but are split based on their main characteristics e.g. predominantly obsessional thoughts, predominantly compulsions, mixed, etc.

Personally I think the DSM's view in splitting hoarding out is a bad call. OCDers have a habit of switching themes or adding new ones. A hoarder could end up with OCD and that hoarding disorder when they may be the same thing? It's strange how we have 2 major manuals and they disagree on all this! I think this is a issue of debate between them e.g. they have started moving impulse disorders (skin picking, hair pulling, for instance) into OCD and there seems to be a lack of agreement on this.

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I know it sounds awful, but I genuinely feel like people would take me more seriously if I could tell them my behaviour is down to OCD and not have to explain away the stigma of a hypochondriac.

Perhaps you do have OCD? There are others on here who have OCD and have health themes e.g. HIV/AIDS, fear of more serious mental illness (often schizophrenia), contraction of diseases, etc.

People probably see hypochondriacs in a more negative light but it's not great with OCD either as that's often portrayed as a lesser issue because of all the people who like washing things who then say "I'm a wee bit OCD" :doh: when they really aren't.

Celebrities latched onto the OCD things years ago, they often get vilified for it by real OCD sufferers on social media. OCD is also largely portrayed as hand washing, hoarding and checking locks and the reality is that it's quite diverse.

[JosieLouise]

We have no OCD Spectrum Disorders group, hence OCD sits on it's own. As does GAD, both of which are under the umbrella term of HA.

All of the above sit within "Neurotic, stress-related and somatoform disorders" group. Within this GAD sits within sub group "Other anxiety disorders" whereas OCD sits within subgroup "Obsessive-compulsive disorder". Then you have those Somatoforms I mentioned that sit within subgroup "Somatoform disorders".

Wow, never knew this was so complex :shrug: I've had people mention GAD a few times, but never an official diagnosis. I have a lot of anxiety about other areas of my life too and never thought about the possibility that HA could be related to that.

Thank you MyNameIsTerry for your detailed reply :) This is interesting.

[swgrl09]

Huh, that's extremely interesting, Terry. Yes, we use DSM V as our main diagnostic criteria, although we use alphanumeric codes from the ICD 10 to bill our insurance companies - go figure!!! When we were getting trained on it at work, it was such a headache. This all went live last fall. So if I were to diagnose somebody with GAD, I would have to write "F41.1 [ICD 10 code] Generalized Anxiety Disorder [DSM V description]." It's a headache.

It is definitely strange how different they categorize the disorders. The DSM V has a chapter for "Obsessive Compulsive and Related Disorders" and a separate chapter for "Somatic Symptom and Related Disorders" so you are correct about that, they aren't in the same chapter anymore when they used to be. I'm still getting familiar with where things have moved. DSM V includes a statement about ruling out OCD prior to diagnosis a somatic symptom/illness anxiety disorder due to their similarities. The obsessive compulsive chapter does include body dysmorphic disorder, hoarding disorder, as well as trichotillomania I think. But I agree with you. I think that sometimes we shift what we are obsessing about. So most of the time I obsess over health issues. But sometimes I obsess over other more general things and experience the same difficult thought patterns about things such as work, cleaning my house, etc. It can get pretty blurry to have clear distinctions.

GAD falls under it's own category now of Anxiety Disorders. PTSD is in a category called "trauma and stress related disorders" when it used to fall under the anxiety disorder umbrella.

I guess the reorganization of DSM V is somewhat helpful, as it helps distinguish between some of these disorders with similar symptomatology, however it also is a bit of a pain in the ... rear.