The document discusses several issues surrounding the classification and diagnosis of OCD. It addresses the reliability and validity of diagnoses using tools like the DSM-IV and ICD-10. While studies have found good inter-rater reliability for diagnoses of OCD, there is less consistency between the DSM-IV and ICD-10. The validity of OCD diagnoses can be challenging due to overlap with other disorders and difficulty distinguishing obsessions from normal worries. Culture can also influence the presentation and diagnosis of OCD symptoms.