Obsessive Compulsive Personality Disorder (OCPD) is a diagnosis for people who engage in a pattern of rigidity. It 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.
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 Obsessive Compulsive Personality Disorder, on the other hand, do not experience repetitive obsessions creating 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.
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.
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.