In 2013, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) reclassified obsessive-compulsive disorder (OCD) from an anxiety disorder into its own category: Obsessive-Compulsive and Related Disorders. The current DSM-5-TR retains that structure.
The conditions in this category are sometimes described informally as “OCD spectrum disorders.” Below, we’ll break down the main disorders included in the classification, what they can have in common, and how their treatment differs.
What is obsessive-compulsive disorder?
Obsessive-compulsive disorder (OCD) is a mental health condition involving obsessions and compulsions.
Obsessions are intrusive thoughts, images, urges, feelings, or sensations that feel distressing, unwanted, or difficult to dismiss. Compulsions are repetitive behaviors or mental acts done to reduce distress, feel certain, prevent something bad from happening, or make things feel “right.”
For someone with OCD, compulsions may bring temporary relief, but they also keep the cycle going. The more someone relies on checking, reassurance-seeking, avoidance, rumination, or rituals to feel better, the more urgent the obsessions can feel over time.
Which conditions are considered OCD-related disorders?
In addition to OCD, the DSM-5-TR category of Obsessive-Compulsive and Related Disorders includes several distinct conditions. They are related to OCD, but they are not the same as OCD.
| Condition | Symptoms/Presentation |
| Excoriation disorder | Repeated skin picking that can feel difficult to stop and may cause skin damage, distress, or problems in daily life. Excoriation disorder is considered a body-focused repetitive behavior (BFRB). |
| Trichotillomania | Repeated hair pulling that can feel difficult to stop and may lead to hair loss, distress, or avoidance. Trichotillomania is considered a BFRB. |
| Hoarding disorder | Difficulty discarding possessions, distress about letting items go, and clutter that can interfere with living spaces, safety, or daily life. |
| Body dysmorphic disorder (BDD) | Preoccupation with perceived flaws in appearance, often with behaviors like mirror checking, comparing, grooming, reassurance-seeking, camouflaging, or avoidance. |
These conditions can look very different from one another. What connects them is not that they are “types of OCD,” but the patterns they can share with OCD.
What makes a condition related to OCD?
OCD-related disorders are grouped together because they can share certain patterns: repetitive thoughts, urges, behaviors, avoidance, distress, and a strong sense of feeling unable to stop.
OCD-related disorders often involve a highly repetitive nature to the behavior, a strong sense of feeling compelled to engage in the behavior, and the relief usually from some unwanted or emotional state that is achieved via engagement in the behavior.
Nicholas Farrell, Director of Clinical Development & Programming at NOCD
That throughline can look different depending on the condition. In OCD, compulsions may be used to reduce distress from intrusive thoughts. In hoarding disorder, saving items or avoiding discarding them may reduce the anxiety, grief, guilt, or fear of making the wrong decision. In trichotillomania or excoriation disorder, pulling or picking may be tied to urges, tension, stress, or temporary relief. In body dysmorphic disorder, distress about perceived appearance flaws may lead to checking, comparing, reassurance-seeking, camouflaging, or avoidance.
These similarities help explain why the conditions are grouped together. But they do not mean the conditions are the same—or that they should all be treated the same way.
Are OCD-related disorders treated the same way?
No. OCD-related disorders can share certain patterns, but they are distinct conditions, and treatment should be matched to the person’s symptoms, diagnosis, and needs.
| Condition | Treatment |
| Obsessive-compulsive disorder | Exposure and response prevention (ERP), which helps people face intrusive thoughts, fears, triggers, images, and uncertainty without relying on compulsions for relief. |
| Excoriation disorder | Habit reversal training (HRT) or Comprehensive Behavioral (ComB) Treatment, which help people identify picking triggers, build awareness, and use strategies that reduce skin damage over time. |
| Trichotillomania | HRT or ComB, which help people understand pulling patterns, recognize urges, and practice different competing responses. |
| Hoarding disorder | Cognitive behavioral therapy (CBT), which may focus on decision-making, reducing acquiring, practicing discarding, and changing beliefs about possessions. |
| Body dysmorphic disorder (BDD) | CBT, which may focus on reducing checking, comparing, reassurance-seeking, camouflaging, and avoidance, while helping people respond differently to appearance-related distress. |
Medication may also be helpful for some people, depending on their symptoms and clinical needs. But because these conditions are not all treated the same way, it’s important to work with a therapist who understands the specific disorder—not just the broader category.
Can NOCD help with OCD-related disorders?
If you’re dealing with OCD, body dysmorphic disorder, hoarding disorder, trichotillomania, or excoriation disorder, you don’t have to figure out the right diagnosis or treatment approach on your own. NOCD’s therapists are trained in evidence-based approaches like ERP, HRT, ComB-informed care, and CBT-based treatment, so care can be matched to your symptoms and needs.
If you’re not sure what you’re experiencing, that’s okay. NOCD can help you understand what may be going on and whether specialized therapy is the right fit.
Bottom line
OCD-related disorders are connected by patterns like repetitive thoughts, urges, behaviors, distress, and temporary relief—but they are not all the same condition. Understanding the difference matters, because the right treatment depends on what you’re experiencing.
If you’re not sure whether your symptoms are OCD, BDD, hoarding disorder, trichotillomania, excoriation disorder, or something else, you don’t have to figure it out alone. A therapist trained in OCD-related disorders can help you understand what’s going on and find a treatment approach that fits.
