Obsessive Compulsive Personality Disorder (OCPD)

Obsessive Compulsive Personality Disorder (OCPD) is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Obsessive compulsive personality disorder (OCPD) is a chronic behavioral disorder in which the patient “often exhibit the need for mental and interpersonal control, overconscientiousness, difficulty discarding items, inflexibility, orderliness, and perfectionism” without the patient having insight of the impairment in their life (1)[A].
  • These traits are separate from those associated with obsessive-compulsive disorder (OCD) which is primarily characterized by “anxiety provoking thoughts (i.e., obsessions) and repetitive, ritualistic behaviors (i.e., compulsions)” (1)[A].

Epidemiology

Incidence
  • 1 in 100 people in the United States
  • In systemic studies, OCPD diagnosed about twice as often in males (2,3).

Prevalence
  • OCPD has an estimated lifetime prevalence of 2.1–7.9% (2).
  • Similar rates for men and women

Etiology and Pathophysiology

  • No single, identifiable factor in causing the disorder
  • Theories suggest parental influence by being either unavailable or overly controlling or protective.
  • Relationships of anatomy, receptors, and neurotransmitters are speculative.

Genetics
  • Could play a role, but has not been well studied as a factor in onset
  • Cultural considerations
    • Authoritarian societies or religions may impact early childhood development, which affects personality expression.
    • Of note: Not all rule-bound societies hinder personality expression and OCPD.
    • Traits may be rewarded within that specific cultural or religious context.

Risk Factors

  • No exact cause of OCPD
  • Unavailable, overly controlling, or overly protective parents might play a role.
  • Low serotonin levels

General Prevention

OCPD cannot be prevented.

Commonly Associated Conditions

  • Generalized anxiety disorder (GAD): Apprehensive expectations occur more days than not for at least 6 months for variety of events or activities.
  • Posttraumatic stress disorder (PTSD): Patient was exposed to death, threatened death, actual or threatened serious injury, actual or threatened sexual violence, and the traumatic event is persistently reexperienced.
  • Depressive disorders (dysthymia or major depressive disorder)
  • Alcohol use disorder

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