Obsessive Compulsive Personality Disorder – Difference between OCPD and OCD

People who suffer from this disorder engage in a pattern of rigidity that is expressed by extreme attention to detail, orderliness, perfectionism, precise organization, and rigid social control. This absolute need for control makes it nearly impossible for the person to relax or reduce stress levels and usually directly interferes with social interactions.

Symptoms of Obsessive Compulsive Personality Disorder OCPD

The DSM-5 recognizes eight distinct symptoms of OCPD. Not all of these symptoms are present in every single person suffering from the disorder. However, at least four of the eight must be present for a legitimate diagnosis of the disorder. The symptoms are:

  • A preoccupation with scheduling, ordering, listing, or categorizing of any and all activities, usually to the point of interfering with actually engaging in the activity
  • An insistence for perfection that results in unending efforts towards a task, usually to the detriment of actually completing the task
  • A pattern of skipping leisure activities in order to engage in work activities, despite a lack of economic or outside impetus to do so
  • Displays a strict and rigid set of moral and ethical values
  • An unwillingness to discard objects, even when they have no utility or sentimental value
  • An insistence that all tasks are performed in a specific way that results in a refusal to delegate when there is even the slightest concern that another might do things differently
  • Hoarding of money, even when there is no economic reason to do so
  • Displays stubbornness in almost any and all social interactions

As can be gleaned from these symptoms, OCPD is distinctly different from the similarly named obsessive-compulsive disorder (OCD). The latter may result in seemingly stubborn behavior, but such behavior would generally be a compulsion engaged in to assuage the stress caused by an obsession. People with OCPD, on the other hand, do not experience repetitive obsessions that create stress. Instead, they simply experience a shared obsession with maintaining order and control. The actions they perform directly support the goal of this obsession, as opposed to sufferers of OCD who perform ritualistic actions that relieve stress through repetition, despite rarely supporting the obsession that caused the action to be performed.

Personality Disorders and Substance Abuse

In a study done in 2012 (In-depth study of personality disorders in first-admission patients with substance use disorders) they discovered 46% of the substance abuse (SUD) patients had at least one Personality Disorder (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively).

Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school.

Causes of Obsessive Compulsive Personality Disorder

The causes of obsessive-compulsive personality disorder are almost completely unknown. Testing suggests that it probably has a genetic cause, but also suggests that environmental factors, specifically childhood trauma, may be a contributing or triggering factor as well. It is not associated with drug or alcohol use, either as a cause or as a symptom.

Alcohol & Personality Disorders

According to clinical studies, the prevalence of personality disorders with alcoholism ranges from as low as 22-40% to as high as 58-78%. The studies have focused primarily on antisocial and borderline personality disorders, however, almost the whole spectrum of personality disorders can be encountered in alcohol dependence, such as the dependent, avoidant, paranoid and others.

An Oxford study indicated 40% or alcohol use disorder clients had at least 1 personality disorder. For more in-depth information, see this research alcohol & personality disorders.

Treatment of Obsessive Compulsive Personality Disorder

Similar to just about every other personality disorder, the primary treatment for obsessive-compulsive personality disorder is continuous therapy. Both cognitive and behavioral therapies have shown to be effective in treating the disorder. Additionally, OCPD is one of the rare personality disorders that also respond positively to medication. Fluoxetine has shown some success when used to treat patients with this disorder, though only in combination with therapy.

Primarily, therapeutic treatment for this disorder focuses on identifying stress and learning healthy coping mechanisms.

This usually reduces the need for the patient to engage in absolute control of their environment. Because of the unique way this disorder affects the mind, often even short gaps in therapy will result in significant relapses, which means it is essential for therapy to be continuous once it begins.

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