Diagnosis of OCD follows the guidelines of the DSM-IV-TR. To be diagnosed with OCD, a person must have obsessions and compulsions as outlined within the manual.
Obsessions must be recurrent and persistent thoughts; intrusive images; and the images and impulses must be of the types that are outside of the range of normal worries.
A compulsion becomes noteworthy, or clinically significant, when the patient feels compelled to perform the image in response to the obsession.