mania is now termed trichotillomania (hair-pulling disorder) and has been moved from a
DSM-IV classification of impulse-control di sorders not elsewhere classified to obsessive-
compulsive and related disorders in DSM-5. The DSM-IV “with poor insight” specifier for
obsessive-compulsive disorder  has been refined to allow a distinction between individuals
with good or fair insight, poor insight, and “absent insight/delusional” obsessive-compul-
sive disorder beliefs (i.e., comp lete conviction that obsessive-compulsive disorder beliefs