Obsessive-compulsive personality disorder

Definition

Obsessive-compulsive personality disorder (OCPD) is a mental condition in which a person is preoccupied with:

Rules
Orderliness
Control

Alternative Names

Personality disorder - obsessive-compulsive; OCPD

Causes

OCPD tends to occur in families, so genes may be involved. A person's childhood and environment may also play roles.

This disorder can affect both men and women. It occurs most often in men.

Symptoms

OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). People with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct. In addition, OCD often begins in childhood while OCPD usually starts in the teen years or early 20s.

People with either OCPD or OCD are 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. People with OCPD have feelings that they consider more appropriate, like anxiety or frustration.

A person with OCPD has symptoms of perfectionism that usually begin by early adulthood. This perfectionism may interfere with the person's ability to complete tasks because their standards are so rigid. They may withdraw emotionally when they are not able to control a situation. This can interfere with their ability to solve problems and form close relationships.

Other signs of OCPD include:

Over-devotion to work
Not being able 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

Exams and Tests

OCPD is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms have been.

Treatment

Medicines may help reduce anxiety and depression from OCPD. Talk therapy is thought to be the most effective treatment for OCPD. In some cases, medicines combined with talk therapy is more effective than either treatment alone.

Outlook (Prognosis)

Outlook for OCPD tends to be better than that for other personality disorders. The rigidness and control of OCPD may prevent many of the complications, such as substance use, which are common in other personality disorders.

The social isolation and difficulty handling anger that are common with OCPD may lead to depression and anxiety later in life.

Possible Complications

Complications may include:

Anxiety
Depression
Difficulty moving forward in career situations
Relationship difficulties

When to Contact a Medical Professional

See your provider or mental health professional if you or someone you know has symptoms of OCPD.

References

American Psychiatric Association. Obsessive-compulsive and related disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA, Hopwood CJ. Personality and personality disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 39.

Gordon OM, Salkovskis PM, Oldfield VB, Carter N. The association between obsessive compulsive disorder and obsessive compulsive personality disorder: prevalence and clinical presentation. Br J Clin Psychol. 2013;52(3):300-315. PMID: 23865406 pubmed.ncbi.nlm.nih.gov/23865406/.