OCD is sometimes difficult to distinguish from certain other disorders. Obsessions and compulsions may appear in the con-text of other syndromes, which can raise the question whether the obsessions and compulsions are a symptom of another dis-order or whether both OCD and another disorder are present. A general guideline is that if the content of the obsessions is not limited to the focus of concern of another disorder (e.g., an appearance concern, as in body dysmorphic disorder, or food concerns, as in an eating disor-der) and if the obsessions or compulsions are preoccupying as well as distressing or impairing, OCD should generally be diagnosed.
Diagnostic dilemmas may also arise when it is unclear whether certain thoughts are obsessions or whether, instead, they are ordinary worries, ruminations, overvalued ideas, or delu-sions. In a similar vein, questions may develop about whether certain behaviors constitute true compulsions or whether they should instead be conceptualized as impulses, tics, or addictive behaviors.