Obsessional jealousy: Provisional research criteria and report of 34 cases

Obsessional jealousy is described in DSM-5 under Other Specified Obsessive-Compulsive and Related Disorders, yet operationalized criteria and clinical characterization are lacking. This study aimed to develop and field-test provisional research criteria for obsessional jealousy and describe the clinical features of individuals meeting these criteria.

Provisional research criteria were developed based on DSM-5 descriptions and applied in a self-referred sample of individuals reporting problematic jealousy (n = 58). Participants underwent structured clinical assessment, including best-estimate diagnostic procedures, evaluation of differential diagnoses, and measures of functional impairment. Participants' views on introducing a formal jealousy diagnosis were explored.

Among the participants, 34 (59%) met the provisional research criteria. The criteria showed strong sensitivity but modest specificity, reflecting a deliberately conservative threshold to avoid over-pathologization. All individuals meeting criteria were judged to meet DSM-5 and ICD-11 definitions of mental disorder. Obsessional jealousy was typically recurrent across relationships, with onset in mid-adolescence and clinical significance emerging in early adulthood. Participants showed generally good insight; comorbidity was common with mood and anxiety disorders. Many reported prior help-seeking and ongoing need for treatment. Participants expressed balanced views regarding formal diagnosis, citing both potential benefits and risks.

These findings identify a group of individuals with pervasive, recurrent obsessional jealousy that is distressing, impairing, and not readily explained by existing diagnostic categories. The proposed criteria provide an initial framework for research and clinical development but require further refinement and validation in more representative community and clinical samples, with careful attention to diagnostic boundaries, transcultural aspects, and stakeholder perspectives.