Eating Disorders and Obsessive-Compulsive Disorder: An ...

1993). Over an extended period, compulsions become increasingly time consuming as
they develop into idiosyncratic rules that link a complex set of behaviours and/or mental
acts. Patients with OCD generally acknowledge that their fears are excessive or
unreasonable, and can recognise that the intrusive thoughts originate from within their
own mind, and are not inserted or imposed on the individual from external sources (c.f.
psychosis; American Psychiatric Association, 2000). Refer to Appendix D for a
summary of the DSM-IV-TR diagnostic criteria for OCD.
The lifetime prevalence of OCD has been approximated at 2.5% of the adult
population (American Psychiatric Association, 2000; Gibbs, 1996; Weissman et al.,
1994). Unlike eating disorders, the prevalence of OCD is similar across cultures, with
symptoms of this disorder typically emerging during childhood or adolescence (Gibbs,
1996). During adolescence, OCD is twice as common amongst girls as boys, however
equal prevalence rates among males and females have been reported in adults
(American Psychiatric Association, 2000). Seventy-five per cent of individuals with
OCD will experience at least one major depressive episode in their lifetime, whilst 33%
meet criteria for comorbid depressive disorder at the time they are diagnosed with OCD
(Abramowitz, Whiteside, Lynam, & Kalsy, 2003; American Psychiatric Association,
2000).
The symptoms of OCD have been linked to disordered eating since each eating
disorder category is associated with an intense fear (e.g., gaining weight) that is
accompanied by behaviours that imitate compulsions (e.g., repeated body checking
that alternates with periods of avoidance ). This notion has been articulated in the
DSM-IV-TR, which recognises that preoccupations resembling OCD often emerge in
the realms of eating disorder symptoms. In order to meet the criteria for OCD however,
preoccupations cannot be limited to food, shape, and weight, as this would more likely
constitute the diagnosis of an eating disorder. Nonetheless, the DSM-IV-TR also
stipulates that “when individuals with AN exhibit obsessions and compulsions that are
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