A syndrome characterised by the presence of prominent obsessions, compulsions, hoarding, skin picking, hair pulling, other body-focused repetitive behaviours, or other symptoms characteristic of obsessive-compulsive and related transtorno that is judged to be the direct pathophysiological consequence of a transtorno or disease not classified under Mental and behavioural transtornos, based on evidence from the history, physical examination, or laboratory findings. The symptoms are not accounted for by Delirium or by another Mental and behavioural transtorno, and are not a psychologically mediated response to a grave medical condition (e.g., repetitive ruminations in response to a life-threatening diagnosis). This category should be used in addition to the diagnosis for the presumed underlying transtorno or disease when the obsessive-compulsive or related symptoms are sufficiently grave to warrant specific clinical attention.