Which statement best reflects the DSM-5-TR criteria for obsessive-compulsive disorder regarding time commitment?

• A. OCD requires obsessions and compulsions to be present for less than 30 minutes daily.
• B. OCD can be diagnosed if symptoms are mild and do not cause impairment.
• C. OCD is diagnosed when obsessions are present but compulsions are not required.
• D. Time-consuming (>1 hour/day) or cause distress/impairment.

Answer: (D)

Duration and functional impact of symptoms determine whether OCD is diagnosed. In DSM-5-TR, obsessive-compulsive disorder is defined by obsessions and/or compulsions that are time-consuming—taking more than one hour per day—or that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. This emphasis on how much time symptoms consume or how badly they disrupt life is why the statement describing time commitment (>1 hour per day) or distress/impairment is the best reflection of the criteria. The other choices miss this threshold: spending less than 30 minutes doesn’t meet the time criterion; mild symptoms without impairment don’t meet the impairment requirement; and while obsessions can occur with or without compulsions, the diagnosis still hinges on the combination of time spent and/or the resulting distress or impairment rather than simply the presence of obsessions or compulsions.