Primarily obsessional obsessive–compulsive disorder

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Primarily obsessional obsessive–compulsive disorder, also known as purely obsessional obsessive–compulsive disorder (Pure O), is a lesser-known form or presentation of OCD. Although it is not a standalone diagnosis in the DSM-5, the International OCD Foundation (IOCDF) recognizes it as a distinct presentation of OCD. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. Primarily obsessional OCD takes the form of intrusive thoughts often of a distressing, sexual, or violent nature (e.g., fear of acting on impulses). According to the DSM-5, "The obsessive-compulsive and related disorders differ from developmentally normative preoccupations and rituals by being excessive or persisting beyond developmentally appropriate...

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