What is the defining feature of Obsessive-Compulsive Disorder in DSM-5-TR?

• A. Recurrent panic attacks.
• B. Delusions and hallucinations.
• C. Elevated mood with increased energy.
• D. The presence of obsessions and/or compulsions that are time-consuming or cause distress or impairment, with clinically significant impairment; symptoms are ego-dystonic.

Answer: (D)

The defining feature of OCD in DSM-5-TR is the presence of obsessions and/or compulsions that are time-consuming or cause distress or impairment, with the symptoms being ego-dystonic. Obsessions are intrusive, unwanted thoughts, urges, or images that trigger anxiety. Compulsions are repetitive behaviors or mental acts performed to reduce that anxiety or prevent a feared outcome. What makes OCD distinctive is that these thoughts and actions intrude on daily life and are recognized by the person as unwanted and inconsistent with their own values (ego-dystonic), often leading to significant distress or impairment.

Other options describe features of different conditions: panic attacks are typical of panic disorder; delusions and hallucinations point to psychotic disorders; and elevated mood with increased energy characterizes mania.