Diagnosis of OCD According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) to be diagnosed with OCD a person must have obsessions compulsions or both. The thoughts impulses or images that are obsessions are of a degree or type that lies outside the normal range of worries about conventional problems. A person may attempt to ignore or suppress such obsessions or to neutralize them with some other thought or action and will tend to recognize the obsessions as distinctive or irrational. Compulsions become clinically significant when a person feels driven to perform them in response to an obsession