In this series, I dig a little deeper into the meaning of psychology-related terms. This week’s term is obsessive compulsive personality disorder.
When people say that someone is “a little OCD,” chances are, what they’re referring to has little, if anything, to do with obsessive compulsive disorder. What they’re talking about is actually far more like obsessive compulsive personality disorder (OCPD) than OCD. Granted, most people haven’t heard of OCPD, but it’s a lot closer to the popular OCD stereotype than OCD itself is.
OCPD symptoms
OCPD involves a pattern of persistent preoccupation with order and control, as well as perfectionism. It’s in the DSM-5’s cluster C of personality disorders. In the World Health Organization’s International Classification of Diseases (ICD-11), it’s called anankastic personality disorder.
Obsessive compulsive personality disorder symptoms include:
- preoccupied with details, rules, schedules, organization, and lists
- perfectionism to the extent that it interferes with completing tasks
- leisure activities and friends are neglected in favour of excessive work and productivity
- unwillingness to get rid of worthless objects that don’t serve a purpose
- reluctant to delegate work to others because they can’t be trusted to do it the right way
- avoidance of spending money out of concern for future disasters
- rigidity and stubbornness
Like any personality disorder, symptoms have already begun by early adulthood, and they cause significant impairment in overall functioning. It’s “normal” for people to have some of these traits, to some extent, some of the time, but if you’re like me and lists and organization make your life easier rather than making it hard, that’s not a disorder.
People with OCPD also tend to be very rigid, with black-and-white thinking, a strong need for control, and difficulty adapting to change. They tend to be deferential to authority, not accept any bending of rules, and have a rigid moral code. Their inflexibility and excessive amounts of time spent on details causes inefficiency and delays in getting things done. Difficulties with compromise and attempts to control others and get them to do things their way (which is seen as the “correct” way) can contribute to difficulties in interpersonal functioning.
OCPD occurs in between 2-8% of the population, and it may be more common in males, although that finding hasn’t been consistent. There appears to be a heritable component, although specific involved genes haven’t been identified.
The difference between OCD and OCPD
Obsessive thoughts in OCD are often ego-dystonic, meaning they’re intrusive, unwanted thoughts that have barged into their heads and are inconsistent with who they are. Someone with contamination OCD doesn’t develop those obsessions and compulsions because they’re hyper-preoccupied with cleanliness, and there is no possible clean that could ever be decontaminated enough to satisfy the OCD.
In obsessive compulsive personality disorder, thoughts tend to be ego-syntonic, so they’re consistent with what the person actually wants and believes. Someone with OCPD might want their house cleaned in exactly a certain way because that’s the only “right” way to do it. Friction can develop in social relationships because of the need for control on the part of the person with OCPD.
Between 15-28% of individuals with OCD have comorbid OCPD. OCPD commonly co-occurs with mood and anxiety disorders.
Treatment
Treatment can be difficult, especially since part of OCPD is believing that one is doing things the “right” way. As a result, people with the disorder may not have enough insight to see the need for treatment. In terms of pharmacotherapy, some benefits have been shown from the SSRI antidepressant fluvoxamine and the mood stabilizer carbamazepine.
In terms of psychotherapy options, cognitive behavioural therapy (CBT) can be helpful, and it’s been associated with decreased anxiety related to OCPD symptoms. Interpersonal therapy and schema therapy may be helpful for depressive symptoms in patients with OCPD, and psychodynamic psychotherapy may help patients to develop greater insight.
During my nursing career, I don’t think I ever worked with any clients diagnosed with OCPD. I can’t think of anyone I knew socially that seemed to have it, either. But the people I’ve known who fit the colloquial description of being “a little OCD” were definitely far closer to OCPD than OCD.
Is this a disorder that you were familiar with? And does it sound to you like there’s a resemblance to the way “a little OCD” gets used inappropriately?
Further reading: Top workplace struggles of people with obsessive-compulsive personality disorder (OCPD) by She Seems Normal
References
- Diedrich, A., & Voderholzer, U. (2015). Obsessive-compulsive personality disorder: A current review. Current psychiatry reports, 17(2), 1-10.
- International OCD Foundation
- OCD UK
- Rowland, T. A., Jainer, A. K., & Panchal, R. (2017). Living with obsessional personality. BJPsych Bulletin, 41(6), 366-367.
- Thamby, A., & Khanna, S. (2019). The role of personality disorders in obsessive-compulsive disorder. Indian Journal of Psychiatry, 61(Suppl 1), S114.
- Wikipedia
- Zimmerman, M. (2021). Obsessive compulsive personality disorder (OCPD). Merck Manual Professional Version.
Other personality disorders in the What Is… series
- Cluster A:
- Cluster B:
- Cluster C:
The Psychology Corner has an overview of terms covered in the What Is… series, along with a collection of scientifically validated psychological tests.
Ashley L. Peterson
BScPharm BSN MPN
Ashley is a former mental health nurse and pharmacist and the author of four books.
I would replace ‘you’re a little ocd’ with ‘you’re a little anal’ because it just sounds so much more fun to me!
On a serious note, people throw these diagnosis around like there’s no tomorrow. I think OCPD is a serious condition and it’s not to used that lightly.
I’m no expert but when I’ve worked with mothers and their babies, I’ve seen a baby getting cought up in a a very controlling cycle. The baby was actually rebelling and disrupting the mother’s habits and she needed to change. In a way the baby was a true gift.
It was very hard though to find a balance that was also comfortable for the mother.
Absolutely, it’s a mental illness that deserves to be taken seriously like any other.
Great overview of the differences. It can be confusing to people who haven’t studied the DSM like us nerds lol.
Nerd power!!!
Is this a disorder that you were familiar with? And does it sound to you like there’s a resemblance to the way “a little OCD” gets used inappropriately?
This is one disorder that has thankfully ‘mostly’ skipped me and my family members who have mental illness. However there is overlap for me with my social phobia concerns, and particularly with pre-occupation (as such) of ‘dirty’ surfaces at public places like swimming pools. The isolation recently has worsened that and I suspect it will be extremely difficult for me to go to a public pool (even a private one) in the future. So far (touch wood) public restrooms aren’t a problem.
There is definitely a resemblance in the way I’ve used “OCD”. Thanks for explaining the difference today!
I would imagine that there are going to be a lot of people struggling with more exposure again post-COVID.
Thank you, very interesting.
A truly amazing article. Thank you for raising awareness on this. And I totally agree with you – OCPD is a lot closer to the popular OCD stereotype than OCD itself and this is something that actually took some time for me to realize like…..at the beginning of my OCD journey I did not use to understand why people were surprised that I had OCD. And over the years, I have learnt that for many of them, OCD actually meant OCPD.
Hope it’s okay if I link to this post in some of my articles 🙂
Cheers
Mark
Of course! Thanks!
Even though I know what true OCD is, I still say it jokingly. I have a huge preoccupation with lists, order, and numbers, mostly happily because I think it’s good (and right!), but sometimes it’s intrusive and annoying. Forex, you (your fault!) said we should add alt text to out media, right? Well, it bothered me to only have it going forward. Guess who spent hours adding it to EVERY PHOTO uploaded since my blog began in 2010? I am done now and feel very accomplished lol
Guilty as charged! 😁
Obsessive Compulsive Personality Disorder of telehealth for depression can be a challenging condition to understand, but it’s essential to remember that those affected by it often struggle with a relentless pursuit of perfection and control in their lives