disorder is most common in males with onset of OCD in childhood. These individuals
tend to differ from those without a history of tic disorders in the themes of their OCD
symptoms, comorbidity, course, and pattern of familial transmission. A triad of OCD, tic
disorder, and attention-deficit/hyperactivit y disorder can also be seen in children.
Disorders that occur more frequently in individuals with OCD than in those without
the disorder include several obsessive-compulsive and related disorders such as body
dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-pick-
ing) disorder. Finally, an association betw een OCD and some disorders characterized by
impulsivity, such as oppositional de fiant disorder, has been reported. 
OCD is also much more common in individuals with certain other disorders than
would be expected based on its prevalence in  the general population ; when one of those
other disorders is diagnosed, the individual should be assessed for OCD as well. For ex-
ample, in individuals with schizophrenia or  schizoaffective disorder, the prevalence of
OCD is approximately 12%. Rates of OCD are also  elevated in bipolar disorder; eating dis-
orders, such as anorexia nervosa and bu limia nervosa; and Tourette’s disorder.
Body Dysmorphic Disorder
Diagnostic Criteria 300.7 (F45.22)
A. Preoccupation with one or more perceived defects or flaws in physical appearance that
are not observable or appear slight to others.  
B. At some point during the course of the disorder, the individual has performed repetitive
behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seek-
ing) or mental acts (e.g., comparing his or her appearance with that of others) in re-