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Obsessive-Compulsive Personality Disorder

When Everything Has to Be "Just Right"

Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder involving an overwhelming need for organization, order, and perfection. A personality disorder affects a person's actions and thoughts negatively, hampering their ability to deal with common life issues and relate to others. When someone has OCPD, little things take on too much importance. Items such as books on a bookshelf and other personal belongings must be arranged in a particular order that satisfies the sensibilities of the person with OCPD. As a result, the person is unable to act efficiently because of the obsession with details. These concerns then interfere with everyday responsibilities, relationships, and a sense of personal well-being.

The cause of OCPD and personality disorders in general is unclear, however it seems to be partially genetic and is more prevalent in men than in women. As a personality disorder, OCPD tends to be a deep-seated, longstanding character trait that is tied closely to the person's sense of self.

Diagnosing OCPD

According to the DSM-IV-TR (psychiatric manual), OCPD is characterized by a "pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts." Its is diagnosed when a person has four or more of the following traits:

Person is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

Person 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)

Person is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)

Person is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

Person is unable to discard worn-out or worthless objects even when they have no sentimental value

Person is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

Person adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes

Person shows rigidity and stubbornness

OCPD and Relationships

People with OCPD struggle socially; most find having relationships extremely difficult and may suffer from clinical depression. Being obsessed with perfection, they may focus on organization and appear anti-social to peers. They are often workaholics. Those with obsessive-compulsive personality disorder who do manage long-term relationships may be demanding toward their partner and children, holding them to the same unrealistic standards they impose on themselves.

Nonetheless, a person with OCPD is generally able to function much better than people with other mental disabilities. They can live a normal life for the most part, and due to the specifics of OCPD, many do not take up substance abuse, which is common to other mental disorders.

OCPD is not the Same as OCD

OCPD may share some of the same symptoms as obsessive-compulsive disorder (OCD), such as a need for order and perfection, but is a different disorder and as such should not be confused. Most people with OCPD do not have OCD, and likewise most people with OCD do not have OCPD. The main difference is that OCD patients are focused on particular distressing obsessions such as repeated hand-washing or abnormal fears of danger. OCPD involves a more broad approach: a constant mindset of order and compulsion. OCPD patients are not distressed by their condition and are in fact comfortable with their behavior, while OCD patients are disturbed by their abnormal thoughts and actions.

Treatment of Obsessive-Compulsive Personality Disorder

There has been very little research on the treatment of obsessive-compulsive personality disorder. Clinical wisdom has focused on long-term cognitive or psychodynamic therapies to help people with OCPD. Because people with OCPD are often anxious or depressed, serotonin reuptake inhibitors, or antidepressants, such as Lexapro, Prozac, or Zoloft, may be prescribed. These may help to reduce anxiety and depression, thereby restoring a sense of normalcy to the patient. However, they do not cure OCPD, and are instead a remedy to be taken repeatedly.

About the Author: Monnica Williams, Ph.D., clinical psychologist, has a specialty practice and interest in OCD and related disorders. An earlier version of this article first appeared at the BrainPhysics OCD Mental Health Resource and is used with permission.

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