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Obsessive-compulsive personality disorder

Definition

Obsessive-compulsive personality disorder (OCPD) is a condition in which a person is preoccupied with rules, orderliness, and control.

Alternative Names

Personality disorder - obsessive-compulsive

Causes, incidence, and risk factors

Obsessive-compulsive personality disorder tends to occur in families, so genes may be involved. A person's childhood and environment may also play roles.

This condition can affect both men and women, but it most often occurs in men.

Symptoms

OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). However, people with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct.

People with both OCPD and OCD tend to be high achievers and feel a sense of urgency about their actions. They may become very upset if other people interfere with their rigid routines. They may not be able to express their anger directly. Instead, people with OCPD experience feelings that they consider more appropriate, like anxiety or frustration.

A person with this personality disorder has symptoms of perfectionism that usually begin in early adulthood. This perfectionism may interfere with the person's ability to complete tasks, because their standards are so rigid.

People with this disorder may emotionally withdraw when they are not able to control a situation. This can interfere with their ability to solve problems and form close relationships.

Some of the other signs of obsessive-compulsive personality disorder include:

  • Excess devotion to work
  • Inability to throw things away, even when the objects have no value
  • Lack of flexibility
  • Lack of generosity
  • Not wanting to allow other people to do things
  • Not willing to show affection
  • Preoccupation with details, rules, and lists

Signs and tests

OCPD can be diagnosed by an experienced mental health professional (psychiatrist or psychologist) with an evaluation. Psychological tests that may help diagnose this condition include:

  • The Structured Clinical Interview for DSM IV Disorders (SCID II)
  • The Schedule for Non-Adaptive and Adaptive Personality (SNAP)

Treatment

Medications such as selective serotonin reuptake inhibitors (for example, Prozac) may help reduce some of the anxiety and depression from this disorder.

However, talk therapy (psychotherapy) is thought to be the most effective treatment for this condition.

  • Psychodynamic psychotherapy helps patients understand their thoughts and feelings.
  • Cognitive-behavioral therapy (CBT) can also help.

In some cases, medications combined with talk therapy may be more effective than either treatment alone.

Expectations (prognosis)

The outlook for people with obsessive-compulsive personality disorder tends to be better than that for other personality disorders. The rigidness and control of OCPD may prevent many of the complications such as drug abuse, which are common in other personality disorders.

However, the social isolation and difficulty handling anger that are common with this illness may lead to feelings of depression and anxiety later in life.

Complications

  • Anxiety
  • Depression
  • Difficulty moving forward in career situations
  • Relationship difficulties

Calling your health care provider

Call for an appointment with your health care provider if perfectionism is interfering with your job or relationships.

References

Moore DP, Jefferson JW. Obsessive-compulsive personality disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 142.

First MB. Personality disorders. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC:American Psychiatric Association; 2000.


Review Date: 11/23/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Michelle Benger Merrill, MD, Instructor in Clinical Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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