Which feature best distinguishes obsessions in OCD from the pathological worry of generalized anxiety disorder?

• A Worry concerns future events whereas obsessions concern past events
• B Worry in GAD does not produce subjective anxiety
• C Obsessions are experienced as intrusive and ego-dystonic and are not restricted to real-life concerns ✓
• D Obsessions are always accompanied by motor tics

Explanation

Both obsessions and GAD worry cause anxiety and distress, so those features do not separate them. The discriminating point is that obsessions are intrusive, unwanted, resisted, and ego-dystonic, and their content extends beyond everyday real-life concerns such as finances or health, which is the typical territory of GAD worry. Temporal focus overlaps between the two conditions and does not distinguish them.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

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