Which diagnosis best fits duration, episodicity, and exclusions?
A
Posttraumatic stress disorder (PTSD)
Exposure to actual/threatened death, serious injury, or sexual violence (direct, witnessed, learning about close person, or repeated indirect exposure)
Presence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both
AA. Exposure to actual/threatened death, serious injury, or sexual violence (direct, witnessed, learning about close person, or repeated indirect exposure) B. ≥1 intrusion symptom: involuntary memories; nightmares; dissociative reactions (flashbacks); intense psychological distress; marked physiological reactions to trauma cues C. ≥1 persistent avoidance: avoidance of trauma-related internal stimuli or external reminders
BA. Presence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both B. Obsessions/compulsions are time-consuming (>1 hr/day) or cause clinically significant distress/impairment C. Not attributable to physiological effects of a substance or another medical condition
Common specifiers
AWith dissociative symptoms (depersonalisation); With dissociative symptoms (derealisation); With delayed expression
BWith good or fair insight; With poor insight; With absent insight / delusional beliefs; Tic-related
BGAD (worry is ego-syntonic, future-focused, realistic - OCD obsessions are ego-dystonic, intrusive, irrational); OCPD (ego-syntonic perfectionism without obsessions/compulsions); MDD (rumination is mood-congruent, not intrusive; no compulsions)