Obsessive-compulsive personality disorder is described in the American Psychiatric Association’s Diagnostic Manual for Mental Disorders (DSM-5).
People with obsessive personality traits often appear to be reserved, stubborn perfectionists, categorical, conscientious, rigid, and anxious. They tend to avoid intimacy and have little pleasure in life. They can be successful, but at the same time indecisive and demanding.
Although there are similarities, this disorder differs from obsessive-compulsive disorder, which is characterized by ritual compulsive and compulsive activities.
Obsessive-compulsive personality disorder symptoms
- Being overly concerned about details, rules, schedules, order, organization, or schedule to the point that the essence of the activity is lost.
- An insistence that others exactly follow their way of doing things or an unreasonable unwillingness to let others get the job done because of a prejudice that they will not do it right.
- Excessive attachment to work and a desire for productivity, to the extent of excluding activities related to recreation and friendships (which are not counted as having any obvious economic necessity).
- Indecision: avoidance of decision making, procrastination, postponement (but not because of an exaggerated need for advice or support from others).
- Excessive conscientiousness, rigor, and inflexibility in matters of morality, ethics, or values.
- Distorted expression of sympathy and affection.
- Insufficient display of generosity and magnanimity (taking time, giving a gift or money) in the absence of personal gain.
- Failure to dispose of worn or unnecessary items, even if they are of no value.
There are typical situations, circumstances, or events that most often trigger or activate the characteristic maladaptive response in obsessive-compulsive personality disorder.
Usually, these are unstructured situations with a lack of authority and/or the presence of demands for close and intimate relationships.
Obsessive-compulsive personality disorder causes
The cause of OCPD is thought to be due to a combination of genetic and environmental factors. There is clear evidence to support the theory that OCPD is genetically inherited, but the significance and influence of genetic factors vary depending on studies, which are somewhere between 27% and 78%. Too little research has focused on a specific gene involved in the inheritance of the disease, and more research is needed to pinpoint the exact genes.
Other studies have found a link between attachment theory and the development of OCPD. According to this hypothesis, people with OCD never developed a safe attachment style, had overbearing parents, received little attention, and were unable to develop empathically and emotionally.
Obsessive-compulsive personality disorder Diagnosis
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, widely used by hand to diagnose mental disorders, places obsessive-compulsive personality disorder according to section II, according to the “personality disorders” chapter, and defines it as: “pervasive picture of absorption with orderliness, perfectionism, mental and interpersonal control through flexibility, openness and efficiency, beginning in early adulthood and present in different contexts. ” OCPD is diagnosed only when four of the eight criteria are met.
An alternative model for diagnosis
DSM-5 also includes an alternative set of diagnostic criteria according to the dimensional model of conceptualizing personality disorders. According to the proposed set of criteria, a person receives a diagnosis only if there is a violation in two of the four spheres of his personality functioning and in the presence of three of the four pathological features, one of which must be severe perfectionism.
The patient must also meet the general criteria C to G for personality disorder, which states that the traits and symptoms displayed by the patient must be stable and unchanged over time, with at least adolescence or early adulthood visible in various manifestations. situations not caused by another mental disorder, not caused by a substance or disease, as well as abnormal compared to the level of human development and culture/religion.
There are several psychiatric disorders in the DSM-5 that are listed as differential diagnoses for OCPD. Here they are:
- Obsessive-compulsive disorder. OCD and OCPD have similar names, which can be confusing; however, OCD can be easily distinguished from OCD: OCD does not have true obsessions or compulsions.
- Accumulation disorder. An accumulation disorder diagnosis is considered only if the accumulation behavior displayed causes serious disturbances in the person’s functioning, for example, inability to access rooms in the house due to excessive accumulation.
- Narcissistic personality disorder. People with narcissistic personality disorder may believe that they are perfect and that no one else can be as “perfect” or “right” as they are; however, people with narcissistic personality disorder usually believe that they are perfect and cannot get better, whereas people with PCD do not believe that they are perfect and are self-critical. People with NPD tend to be stingy and lacking in generosity; however, they are usually generous when they spend on themselves, unlike those with an OCPD who save money and are stingy with themselves and others.
- Antisocial personality disorder. Likewise, people with antisocial personality disorder do not show generosity and stinginess towards others, although they usually indulge themselves excessively and sometimes spend money recklessly.
- Schizoid personality disorder. Schizoid personality disorder and obsessive-compulsive personality disorder may exhibit limited affectivity and coldness; however, in OCPD this is usually due to a controlling attitude, while in SPD it is due to a lack of the ability to experience emotion and show affection.
- Other personality traits. Obsessive-compulsive personality traits can be especially helpful and beneficial, especially in a work environment. It is only when these traits become extreme, maladaptive, and cause clinically significant impairments in several aspects of life that a diagnosis of OCPL should be considered.
- Personality change due to another medical condition. Obsessive-compulsive personality disorder must be distinguished from personality change caused by a disorder that affects the central nervous system and can cause changes in behavior and character traits.
- Substance use disorders. Substance use can cause obsessive-compulsive traits. This must be distinguished from the underlying and ongoing behavior that must occur when the person is not under the influence of the substance.
The World Health Organization’s ICD-10 uses the term anankastic personality disorder ( F60.5 ). Anankastic comes from the Greek word ἀναγκαστικός ( Anankastikos: “compulsion”).
The criteria for disorder are broadly similar to those of the DSM-5, with the greatest difference in the absence of accumulation as a diagnostic criterion. According to this set of criteria, a person can be diagnosed only if four of the eight established criteria are met. ICD-10 also requires the diagnosis of any particular personality disorder to meet a set of general criteria for personality disorder.
Treatment for Obsessive-compulsive personality disorder
Only qualified therapists can diagnose the disease, for the confirmation of which a special psychological test and analysis are needed. A self-made diagnosis will almost always be erroneous and a person will not be able to deal with the problem. It usually only gets worse.
The most effective treatments for OCPD include cognitive-behavioral therapy (CBT) and medication. In some cases, treatment for Obsessive-compulsive personality disorder may require other forms of therapy, including surgery.
The assistance needed is usually provided by a mental health professional on an outpatient basis. This means that the patient visits their therapist’s office at the appointed time one or more times a week. Medications can only be prescribed by qualified healthcare professionals who will work with a therapist to develop a treatment