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Obsessive-compulsive personality disorder

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

Alternative Names

Personality disorder - obsessive-compulsive

Causes, incidence, and risk factors

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 most often occurs in men.

Symptoms

OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). But 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

Signs and tests

OCPD is diagnosed based on a psychological evaluation that assesses the history and severity of the symptoms.

 

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.

Expectations (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 drug abuse, 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.

Complications

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

Calling your health care provider

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

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personalitydisorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.

Updated: 11/17/2012

Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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