What Tests Are Used to Diagnose OCD?

It’s only four letters, but the word test can conjure unwelcome bouts of uneasiness. Fortunately for those seeking to be tested for obsessive-compulsive disorder (OCD), a mental health condition that is defined by repeated thoughts or compulsions and affects 2.2 million Americans, the process is relatively simple.   

There’s no blood test, no brain scan, no physical exams — just a series of questions, really. Read on to learn more about the tests and techniques mental health professionals use when working to diagnose the disorder.

What exactly are these tests?

“To diagnose OCD, trained therapists will ask questions to determine if you meet the criteria outlined in the DSM-5 for the disorder,” Keara Valentine, Psy.D., a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, says.

For the uninitiated, DSM-5 stands for Diagnostic and Statistical Manual of Mental Disorders and, according to the American Psychiatric Association, it is the product of years’ worth of research by hundreds of health professionals across the globe.

Within DSM-5, many therapists will turn to SCID-5, which stands for Structured Clinical Interview for DSM-5. “[They] use structured diagnostic interviews … or other inventories to assess symptoms of various mental health diagnoses to rule out other differential diagnoses,” Valentine explains.

In most OCD-suspected cases, however, “trained OCD therapists will administer the Yale-Brown Obsessive Compulsive Scales (Y-BOCS), which assesses the obsessions and compulsions one has, as well as the severity of symptoms.”

Why doesn’t testing involve a blood test or an X-ray? Can OCD even be seen on a brain scan? 

Technology and laboratory analysis are constantly evolving, but at the time of writing this article, there is no blood test or X-ray that can diagnose OCD. And even though OCD is a mental disorder, a brain scan is incapable of spotting it.

“Neuroimaging studies indicate that there may be differences in the neuroanatomy of people with OCD, and this area of the field is constantly developing,” Valentine shares. “However, OCD is still diagnosed through interviews.”

What is a health professional looking for when they diagnose the disorder?

There’s no prep for OCD testing, so just go as you are. But if you’re curious what your therapist will be looking for, Valentine says that experts will keep their eyes peeled for certain symptoms that line up with DSM-5 criteria—so, symptoms like obsessions*, compulsions** or both. 

Your therapist will want to know how time-consuming these acts are — Valentine mentions an hour per day might be a red flag — and if they’re roadblocks in any way to daily life (be it work, play, etc.). Further, determining that these acts are not connected in any way to substance abuse, including alcohol and prescription medication, is a must, as is ruling out any other mental disorder that may be causing the obsessive behaviors, such as generalized anxiety disorder.

“One thing I always drive home for people is that if the thoughts are unwanted and distressing, and the symptoms interfere with functioning and/or are distressing,” OCD might be to blame, Valentine says. 

Are there any risks to testing for OCD?

Sure. There are risks just leaving the house, right? But rest assured that the risks involved with testing for OCD are minimal. For instance, you could become uncomfortable while talking about your symptoms. 

That’s not to minimize your situation, but rather just to say, “When you are being evaluated for OCD by a trained professional with specialty in OCD, you are not going to say anything we haven’t heard before,” Valentine says. Read: You’re in good hands.

Is OCD hereditary?

Good question. According to a 2013 study published in Depression & Anxiety, researchers found that “the risk of OCD in the case probands was significantly increased when first‐degree family members had either OCD, or tic disorders, or affective disorders, or anxiety disorders.”

So, yes, it is genetic, partially. But just because your mother or sister has the disorder doesn’t mean you will also. “Research has not identified specific genes associated with OCD,” Valentine explains.

For further information regarding twins, risk factors, and more, go here.

What happens after you get diagnosed with OCD?

According to Valentine, OCD treatment can come with some hurdles, like too few exposure and response prevention (ERP) therapists, no insurance compliance and other financial issues. “This, combined with the fact that a lot of individuals feel their OCD is not severe enough to warrant treatment, can lead to significant delays in starting ERP after diagnosis,” she shares.

Try not to let these barriers deter you though. ERP treatment can offer much relief. And “there is power in knowledge, and receiving an accurate diagnosis can help ensure you are receiving the right treatment.” A helpful tip? Seek a diagnosis from a provider who is also a trained ERP therapist. That way, there are no negative surprises.

Can I diagnose myself?

No one knows you better than you, but no one knows OCD better than the experts, says Valentine. Some things are better left to health professionals. “Diagnosis can be difficult, and I always recommend being evaluated by a therapist with specialized training in OCD and ERP,” she says.

However, if you are still curious to explore the option of taking an online OCD test, we suggest trying our OCD Quiz. This brief screener created by Dr. Jamie Feusner and Dr. Stephanie Lonsway, OCD experts on NOCD’s clinical team can potentially help you determine if you have OCD symptoms.

What are some good resources for getting diagnosed?

Valentine suggests the International OCD Foundation website for a list of OCD-expert therapists. And, of course, the site you are on right now has a digital library’s worth of content, including virtual services to help connect you with licensed providers.

*Obsessions are defined by (1) and (2):

1. Recurrent and persistent thoughts, urges or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.

2. The individual attempts to ignore or suppress such thoughts, urges or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).

**Compulsions are defined by (1) and (2):

1. Repetitive behaviors (e.g., handwashing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

2.The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.

Note: Young children may not be able to articulate the aims of these behaviors or mental acts.

Footnotes provided directly by Dr. Valentine.