It is unclear whether patients with obsessive-compulsive disorder (OCD) and expert clinicians agree on the symptoms’ qualities that are essential for a diagnosis of OCD. This study examined whether OCD patients and expert clinicians agree on the essential characteristics for an OCD diagnosis. It compared the endorsement rates of various descriptive terms and assessed whether response profiles could predict group membership (patients versus expert clinicians).

Sixty-four OCD patients and 36 OCD expert clinicians answered a questionnaire on their views regarding the defining characteristics of OCD symptoms. It included a compilation of adjectives extracted from DSM-5 to describe disorders in the compulsive–impulsive spectrum. Chi-square tests compared response prevalence between groups and binary regression identified distinguishing features. The significance level was set at 0.05.

All descriptors differed significantly between OCD patients and expert clinicians (p < 0.01), with clinicians consistently endorsing more items as applicable or essential. Although the logistic regression model significantly distinguished the 2 groups and showed high explanatory power (R2 = 0.7) with 99% classification accuracy, no individual descriptors were significant predictors.

There is a mismatch between clinician-defined diagnostic language and patients’ subjective experience of OCD, including core symptom descriptors. This gap suggests that current OCD diagnostic construct may not fully capture how patients perceive their condition, potentially limiting its validity and clinical utility. Adopting more patient-centered language could improve assessment, psychoeducation, and treatment engagement.