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Obsessive-Compulsive Personality Disorder

Dsm, Obsessive Compulsive

Obsessive Compulsive Personality Disorder is often confused with the better-known Obsessive-Compulsive Disorder (OCD). Despite this, these are entirely different disorders. In this article, I will describe this often misunderstood personality disorder, as well as explain some of the differences between OCPD and OCD.

The defining feature of Obsessive-Compulsive Personality Disorder (OCPD) is a fixation with orderliness, perfectionism, and mental and interpersonal control. This disorder generally begins by early adulthood. Individuals who have Obsessive-Compulsive Personality Disorder try to maintain a sense of control through meticulous focus on rules, unimportant details, procedures, lists, schedules, or form (DSM-IV-TR, 2000).

People with Obsessive-Compulsive Personality Disorder often get so caught-up in minor details that they fail to complete necessary tasks. These individuals are extremely careful and prone to repetition, paying close attention to detail and inspect their work repeatedly for mistakes. OCPD patients are usually oblivious to the level of frustration that others experience when this scrutiny leads to delays or incomplete tasks.

Patients with Obsessive-Compulsive Personality Disorder tend to manage their time very poorly. Someone with OCPD may spend hours looking for a lost item, rather than simply moving on and looking for it later. Repeating tasks over and over also “wastes” a lot of time. This extreme perfectionism experienced by OCPD patients can lead to major distress and dysfunction.

Individuals with Obsessive-Compulsive Personality Disorder may be overly conscientious, scrupulous, and rigid in matters of morality, ethics, or values (DSM-IV-TR). Rules and regulations are very important to OCPD patients, as well. They frequently insist on literal compliance with any rules, with no exceptions. This rigidness often causes interpersonal difficulties, as OCPD patients often attempt to force their beliefs on those around them. There is one “correct” way to do things, and are not willing to listen to other people’s ideas.

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These individuals are sometimes miserly or stingy with their money and other resources. OCPD patients may maintain a standard of living that is far below what they ca afford, “just in case.” People with Obsessive-Compulsive Personality Disorder rarely lend money to family or friends.

The main difference between Obsessive-Compulsive Personality Disorder and the better known Obsessive Compulsive Disorder (OCD) is the actual obsessions and compulsions. Obsessions and compulsions are the primary characteristics of OCD, while true obsessions or compulsions are not present in those with Obsessive-Compulsive Personality Disorder (DSM-IV-TR). In this sense, the name can be misleading, and sometimes confusion to lay-people.

DSM-IV-TR Diagnostic Criteria for Obsessive Compulsive Personality Disorder

Beginning in early adulthood and present in a variety of contexts, as indicated by 4 (or more) of the following:

  1. is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
  2. shows perfectionism that interferes with task completion (e.g. is unable to complete a project because his or her own overly strict standards are not met)
  3. is excessively devoted to work and productivity to the exclusion of leisure activities ad friendships (not accounted for by economic necessity)
  4. is over conscientious, scrupulous, ad inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
  5. is unable to discard worn-out or worthless objects even when they have no sentimental value
  6. is reluctant to delegate tasks or to work with others unless they submit to exactly his or her own way of doing things
  7. adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
  8. shows rigidity and stubbornness
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(DSM-IV-TR 2000, p 729)

Treatment

If you or someone you know suffers from Obsessive-Compulsive Personality Disorder, there are several types of treatment that can be effective.

Psychotherapy. The most popular of these treatment options is psychotherapy. As with most of the personality disorders, therapy is frequently focused on short-term symptom relief and the support of existing coping mechanisms while teaching new ones. There is no “cure” for personality disorders. The objective in treatment is to learn to cope with and live more effectively and happily with the disorder.

Medication. It is unusual for medication to be prescribed for OCPD, unless there is another disorder present. However, SSRIs (Selective Serotonin Re-uptake Inhibitors) such as Prozac have been effective in treating individuals suffering from OCD, and some researchers think that OCPD patients will have the same benefit. Research is still being conducted to determine the effectiveness of these SSRI drugs.

Self-Help. While self-help shouldn’t be the only form of treatment for an individual with Obsessive-Compulsive Personality Disorder, it can be helpful. Support groups are often included in this category of treatment and can be quite effective.

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