- Obsessive-Compulsive Personality Disorder (OCPD) – Psychiatric Disorders – Merck Manuals Professional Edition
- The role of personality disorders in obsessive-compulsive disorder
- OCD vs. OCPD: 5 Differences
- Difference #1: Insight
- Difference #2: Distress
- Difference #3: Guilt
- Difference #4: Anxiety
- Difference #5: Time
- OCD vs OCPD: Symptoms and Treatments
- Obsessive-Compulsive Disorder
- Obsessive-Compulsive Personality Disorder
- OCPD vs. OCD
- Characteristics of OCPD
- OCD Traits and Characteristics
- Differentiating OCPD from OCD
- Treatment Methods
- Key Points: OCPD vs. OCD
- Understanding OCD Versus OCPD
- What is OCD?
- What is OCPD?
- OCD vs OCPD: Explained
- OCPD & Splitting
- Differences Between OCPD VS OCD
- OCD VS OCPD
Obsessive-Compulsive Personality Disorder (OCPD) – Psychiatric Disorders – Merck Manuals Professional Edition
Symptoms of obsessive-compulsive personality disorder may lessen even over a time period as short as 1 year, but their persistence (ie, remission and relapse rates) during the long term are less clear.
In patients with obsessive-compulsive personality disorder, preoccupation with order, perfectionism, and control of themselves and situations interferes with flexibility, effectiveness, and openness. Rigid and stubborn in their activities, these patients insist that everything be done in specific ways.
To maintain a sense of control, patients focus on rules, minute details, procedures, schedules, and lists. As a result, the main point of a project or activity is lost. These patients repeatedly check for mistakes and pay extraordinary attention to detail.
They do not make good use of their time, often leaving the most important tasks until the end. Their preoccupation with the details and making sure everything is perfect can endlessly delay completion. They are unaware of how their behavior affects their co-workers.
When focused on one task, these patients may neglect all other aspects of their life.
Because these patients want everything done in a specific way, they have difficulty delegating tasks and working with others. When working with others, they may make detailed lists about how a task should be done and become upset if a co-worker suggests an alternative way. They may reject help even when they are behind schedule.
Patients with obsessive-compulsive personality disorder are excessively dedicated to work and productivity; their dedication is not motivated by financial necessity. As a result, leisure activities and relationships are neglected.
They may think they have no time to relax or go out with friends; they may postpone a vacation so long that it does not happen, or they may feel they must take work with them so that they do not waste time. Time spent with friends, when it occurs, tends to be in a formally organized activity (eg, a sport).
Hobbies and recreational activities are considered important tasks requiring organization and hard work to master; the goal is perfection.
These patients plan ahead in great detail and do not wish to consider changes. Their relentless rigidity may frustrate co-workers and friends.
Expression of affection is also tightly controlled. These patients may relate to others in a formal, stiff, or serious way. Often, they speak only after they think of the perfect thing to say. They may focus on logic and intellect and be intolerant of emotional or expressive behavior.
These patients may be overzealous, picky, and rigid about issues of morality, ethics, and values. They apply rigid moral principles to themselves and to others and are harshly self-critical. They are rigidly deferential to authorities and insist on exact compliance to rules, with no exceptions for extenuating circumstances.
The role of personality disorders in obsessive-compulsive disorder
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OCD vs. OCPD: 5 Differences
A few weeks ago on the Savvy Psychologist podcast, we tackled the most common personality disorder: OCPD.
Listener Amanda M. of St. Louis, who requested the episode, rightly notes that OCPD often gets confused with a very different disorder that has a very similar name: Obsessive Compulsive Disorder, or OCD.
So today, let’s look at 5 important differences between OCPD and OCD:
Difference #1: Insight
Folks with OCD usually know that their thoughts are not exactly reasonable (“Did I turn off the stove? I’d better check,” or “If I wear unmatched socks, something bad will happen to my brother.”)
By contrast, individuals with OCPD believe their sky-high standards and work ethic are not only reasonable, but the only way to get things done.
Difference #2: Distress
In OCD, the obsessions and compulsions are stressful and unpleasant. For instance, feeling convinced you just drove over someone and circling back dozens of times to check for a body turns one’s stomach into knots. By contrast, for those with OCPD, the rigid schedules and rules of the condition are often comforting and feel right.
Difference #3: Guilt
In OCD, individuals can, but not always, feel guilty about asking others to conform to their rituals (for example, “I know it’s a hassle to put on shoe covers whenever you come inside, but I really, really need you to do that. I’m so sorry.”) On the flip side, those with OCPD think others should conform to their methods and firmly believe they’d be better off for it.
Difference #4: Anxiety
With OCD, compulsions – the actions someone with OCD can’t resist doing, checking, counting, or washing – are performed to reduce anxiety. For instance, an individual with OCD might review her schedule for the day over and over again because she’s terrified she’s forgotten to include all her appointments.
By contrast, someone with OCPD might make and review a detailed schedule in order to be comprehensive and efficient. Anxiety isn’t part of the picture.
Difference #5: Time
By definition, OCD takes more than an hour a day.
That’s right – part of an OCD diagnosis can be the fact that the obsessions, plus the compulsions to neutralize the obsessions, suck up a lot of time.
OCPD, on the other hand, is more tightly interwoven to one’s personality. Rather than being an activity unto itself, the perfectionism and control of OCPD is more of a trait, not a time suck.
Quick Tip: Think of the one-letter difference between the two acronyms: OCPD has a “p” in it, which you can pretend stands for “perfectionism,” the defining feature of the disorder.
Any way you slice it, these disorders are tough to live with. The good news? They’re also treatable, particularly OCD. With work and practice, the only difference you’ll think about is what a difference good treatment makes.
Get more savvy by subscribing to the podcast on iTunes or Stitcher, or get the episode delivered straight to your inbox by signing up for the newsletter. Plus, follow me on and .;
OCD vs OCPD: Symptoms and Treatments
Their abbreviated names sound very similar: OCD and OCPD.
But in fact, OCD (obsessive-compulsive disorder) and OCPD (obsessive-compulsive personality disorder) are two very different conditions, each with their own symptoms and treatment plans.
The good news for individuals who have either one is that with appropriate treatment, they can be well managed to the point that the disruption to one’s life is minimized.
“Although some people may have a tough time distinguishing OCD and OCPD from each other by name, they’re quite distinct in the nature of what they are,” says Simon Rego, PsyD, chief psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City.
When it comes to OCD, the lifetime prevalence is about 2.5%, Dr. Rego explains. It’s estimated that about 2 to 8% of people have OCPD, and it’s believed to be twice as common in men as in women.2 Additionally, many people exhibit some of the signature traits and behaviors of OCPD, such as self-limiting perfectionism and rigidity, but don’t have the fully diagnosed personality disorder. 2
Here’s the rundown on these two mental health conditions.
An individual with OCD has frequent, upsetting thoughts (obsessions) that she tries to control by repeating particular behaviors (compulsions).
The obsessions spark a great deal of anxiety because they are not only intrusive and unwanted but also recurrent, Dr. Rego says.
“People with OCD will do anything to combat or escape the obsessions and therefore they resort to extensive compulsions and avoidance,” he explains.
Those with OCD are aware that their obsessions are unreasonable, and they can feel tortured by both the obsessions and compulsive behavior. Typically, OCD starts to develop in later childhood or during adolescence.
1 Symptoms can wax and wane, with symptoms getting better at times and worse at others. “It’s not typical for OCD to start later in life,” Dr. Rego says. “But without treatment, the condition becomes chronic and worsens.
OCD tends to be distressing because the person may realize that her symptoms are impairing her life but still feels compelled to do her compulsions, says Scott Krakower, DO, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, New York.
“For example, someone with obsessive symptoms of germs and contamination may be doing unwanted rituals to stay clean,” he says. “This may ultimately worsen to where it begins to impact relationships and other functioning.”
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Selective serotonin reuptake inhibitors (SSRIs) are commonly used in the treatment of OCD. The most effective form of psychotherapy for OCD is a type of cognitive behavioral therapy (CBT) called exposure and response prevention, says Anthony Pinto, PhD, director of the Northwell Health OCD Center, located at Zucker Hillside Hospital.
“In this form of therapy, the patient works closely with the therapist to gradually approach a situation that the patient finds terrifying, and then the patient learns to cope with their anxiety without relying on their compulsions or avoidance,” Dr. Pinto says. “Touching surfaces in a public restroom and then not washing is an example.
The goal of this treatment is not to limit having the intrusive thoughts, but instead to learn, over time, to be open to them and not react to them in fear.
Both in session and through homework assignments, the person learns to notice and acknowledge the intrusive thoughts without responding with compulsions and, through this process, the person reclaims her life since her routine and functioning are no longer disrupted.
Obsessive-Compulsive Personality Disorder
Individuals with OCPD tend to think their way of doing things is the “right and best way,” and they are fixated with following set procedures or routines in their work or daily living, even when these routines are inefficient. These individuals tend to be overly controlling of their environments or relationships, wanting others to conform to the strict rules they set.
This personality disorder includes maladaptive traits and behaviors, including perfectionism that interferes with completing tasks, rigid following of moral or ethical codes, hoarding behaviors, and an excessive fixation with lists and rules.
2 A person with OCPD has an overwhelming need for order, a strong sense of “how things should be done,” and a rigidity when it comes to following rules. “For someone with OCPD, it’s all about rules and orderliness,” Dr. Rego says.
“The person believes there is a certain right way of doing things, and that is how things should be done even at the expense of relationships.”
A person with OCPD can be successful in work life, he says. “Their perfectionism keeps them at a high standard,” Dr. Rego explains. “That said, others may find the individual with OCPD is difficult to work or live with because of their style of operating.”
The individual with OCPD is preoccupied with perfectionism at the expensive of openness, flexibility, and efficiency, Dr. Krakower says.
Treating OCPD may involve a combination of psychotherapy, medication, and mindfulness techniques. The SSRIs may be helpful because they can make the person feel less distressed and bogged down by minor things.
CBT can be effective for treating OCPD because it targets the individual’s quest for perfectionism and rigidity in thinking and helps focus on the stress that is causing the need to be perfect and organized. “It helps the person identify the distress that is driving her to be so perfect and organized,” Dr. Rego says.
“CBT also helps the person to identify the unattainable standards and rigid rules they are living by and to understand how these things get in their way,” Dr. Pinto says.
“I work with patients to test these standards and rules so that they can come up with more flexible and time-efficient ways of living.
In the process, we also aim to reduce self-criticism and broaden how the person evaluates herself to be various life areas rather than being just achievement.”
- “What is OCD?” National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/what-is-ocd.shtml
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Washington, D.C.: American Psychiatric Publishing; 2013.
OCPD vs. OCD
Though obsessive-compulsive personality disorder (OCPD) may sound obsessive-compulsive disorder (OCD), it is not the same. Both conditions do, however, have a unique ability to create distress as these disorders interfere with a person’s thoughts, feelings actions.
For someone who has one of these disorders, learning the characteristics of and differences between OCPD vs. OCD can help them better understand their condition. With this knowledge, a person can find the best treatments available.
Characteristics of OCPD
As the name implies, OCPD is a personality disorder, which means the condition is more ly to be ingrained into a person’s life.
Typically, personality disorders:
- Last a long time with consistent symptoms
- Are challenging to treat
- Cause significant harm to the person and their relationships
- Start during the late teens or early twenties
Perhaps the most noteworthy characteristic of obsessive-compulsive personality disorder is perfectionism. Having OCPD means that a person has an intense need for perfection in themselves, their actions and the people around them.
Additional signs and symptoms of OCPD include:
- A strict focus on being organized, attention to detail and sticking to schedules
- A lack of leisure time due to being consumed with work
- Being inflexible about moral and ethics, or seeing situations in absolute terms
- Difficulty throwing away old and worthless items
- Being unable to let others help
- Hoarding money
- Being stubborn and set in their ways
- Perfectionism that stands in the way of happiness and healthy relationships
OCD Traits and Characteristics
In contrast to OCPD, OCD is different in that it involves obsessions and compulsions that affect every part of a person’s life. Obsessions and compulsions are the hallmarks of OCD.
Obsessions are characterized by:
- Intense and unwanted thoughts that trigger stress and anxiety
- Thoughts a person tries to block with another idea or a behavior
Compulsions are characterized by:
- Behaviors a person feels driven to complete repetitively
- Behaviors completed that limit the presence of obsessions
The final significant symptom of OCD is spending large amounts of time during the day performing OCD rituals. For example, needing five extra minutes to check the stove does not mean a person has OCD, but spending five hours in the shower might.
Beyond the presence of obsessions and compulsions, OCD can result in:
- High anxiety in all aspects of life
- Poor relationships
- Inability to maintain work or school commitments
- Increased depression
- Extreme discomfort when leaving home
Depending on a person’s condition, their OCD could cause additional repercussions. For example, if the person compulsively washes their hands, they could have dry, cracked skin.
Differentiating OCPD from OCD
When determining if a person struggles with obsessive-compulsive personality disorder vs.
obsessive-compulsive disorder, experts complete a thorough mental health evaluation using the guidelines for diagnosis in The Diagnostic and Statistical Manual of Mental Disorders, fifth (DSM-5).
Professionals may also gather information from friends and family members to get a complete perspective.
Critical elements in differentiating OCPD vs. OCD are the obsessions and compulsions. A person with OCPD will have some rigid behaviors, but they will not engage in the overwhelming need for repetition linked to OCD compulsions.
Another basis for determining OCD vs. OCPD is the level of insight and self-awareness. Most often, a person is fully aware of OCD and the problems it causes, but OCPD is different. A person with OCPD usually believes their thoughts and behaviors are normal, and other people are the ones who need to change.
A mental health professional will also investigate the impact of the condition. Usually, OCD affects all aspects of life, making work, school or healthy relationships impossible. In contrast, OCPD could relate to improved performance at work or school, but relationships with other people are ly to suffer.
A person who is in a relationship with someone who has OCPD may feel:
- a disappointment
- Overly controlled or manipulated
- Frustrated and angry
People with OCD often see the need for treatment while people with OCPD don’t think it will be helpful. A person who has OCPD may encourage their loved ones to seek treatment instead of themselves.
Due to a person’s lack of insight and self-awareness, treatment for OCPD may be more challenging than treatment for other conditions. The preferred treatment for OCPD is talk therapy.
Psychotherapy may focus on achieving short-term goals :
- Reducing stress and learning relaxation techniques
- Improving healthy coping skills
- Building new relationships and strengthening existing ones
- Learning ways to communicate clearly and kindly
If someone responds well to these treatments, the therapy sessions can shift to a long-term treatment plan with a focus on reducing the feelings of perfectionism and their need for control. This form of treatment can be challenging and time-intensive, though.
Typically, OCD treatment follows another course. A form of cognitive-behavioral therapy called Exposure and Response Prevention aims to expose a person to obsessions while preventing their compulsions.
If someone compulsively washes their hands, the therapist may encourage the person to touch something dirty without immediately washing.
Their anxiety will rise initially but then fall with time, making the compulsion unnecessary.
When the compulsions end, the obsessions gradually diminish, making Exposure and Response Prevention an effective treatment.
A psychiatrist may offer medication to help reduce the symptoms of OCD as well. Medications paired with therapy seem to be the most successful treatment methods for OCD.
Conversely, medications are used less frequently with OCPD. If a doctor does prescribe them, it may only be in the short-term to address possible mood or anxiety issues.
By seeking out effective, evidence-based treatments as soon as symptoms arise, a person can significantly improve the prognosis for either OCPD or OCD.
One study of Exposure and Response Prevention shows that treatment can reduce OCD symptoms by between 65 and 50 percent after only 14 therapy sessions.
The benefits of talk therapy and counseling usually continue for months after treatment ends.
with other personality disorders, the outcome of OCPD treatments are less predictable. Although therapy can help a person reduce their need for perfectionism and control, the change takes time. In many cases, it takes an ultimatum from a boss or spouse for a person to accept the need for treatment and engage in the process.
Key Points: OCPD vs. OCD
Learning the difference between the two disorders is challenging. Remember these key OCPD vs. OCD points:
- OCPD is a personality disorder marked by perfectionism and a need for control
- OCD is characterized by obsessions and compulsions that take up a lot of time
- People with OCD are usually self-aware, but people with OCPD typically are not
- The prognosis is generally better for OCD than OCPD, but both conditions improve with treatment
- Treatment for both OCPD and OCD can involve psychotherapy:
- Exposure and Response Prevention helps OCD
- Talk therapy aimed at decreasing perfectionism and aiding relationships helps OCPD
With either OCPD or OCD, the presence of co-occurring conditions depression, anxiety and substance use disorders can complicate treatment, resulting in a poorer prognosis. To find treatment for substance use and co-occurring mental health issues, contact The Recovery Village today.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” Published in 2013. Accessed March 2019.
International OCD Foundation. “Exposure and Response Prevention (ERP).” (n.d.) Accessed March 2, 2019.
Jones, Mairwen K. et. al. “The Efficacy of Exposure and Response Prevention for Geriatric Obsessive Compulsive Disorder: A Clinical Case Illustration.” US National Library of Medicine, National Institutes of Health, published in 2012. Accessed March 2, 2019.
National Institute of Mental Health. “Obsessive-Compulsive Disorder.” Published in January 2016. Accessed on March 2, 2019.
U.S. National Library of Medicine: MedLine Plus. “Obsessive-Compulsive Personality Disorder.” November 18, 2016. Accessed on March 2, 2019.
Van Noppen, Barbara. “Obsessive-Compulsive Personality Disorder (OCPD).” International OCD Foundation, 2010. Accessed on March 2, 2019.
Understanding OCD Versus OCPD
Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) carry traits that overlap, and as a result, both disorders are often used interchangeably.
OCD is a different illness from OCPD, with its own set of symptoms and diagnostic criteria. Below we explain the differences between the two disorders.
What is OCD?
OCD is an anxiety disorder characterized by persistent, recurrent urges, thoughts, and behavior causing distress to the patient. These thoughts or urges transmute into compulsions that occur to try and minimize the distress.
In patients with OCD, compulsions manifest as psychological and physical symptoms.
In mental traits, patients experience unwanted, negative thought patterns, which may trigger insomnia and sudden onset anxiety, or panic attacks.
In traits that are physical, the compulsions may result in repetitive behavior such as checking locks, hand washing, moving objects in specific orders, and compulsive hoarding.
Before diagnosing OCD, other medical conditions and the use of certain substances must be ruled out. And if one is diagnosed, comorbidity with affective or psychotic disorders are common.
What is OCPD?
Now, with OCPD, some of the traits, most notably the unwanted thoughts and repetitive behavior, are present. However, OCPD can be viewed as a severe form of OCD, and therefore is more difficult to treat.
OCPD is a personality disorder characterized by extreme preoccupation with orderliness, perfectionism, interpersonal control, and attention to rules or details. There may be signs of rigidity, stubbornness, and compulsive hoarding. In regards to rules, distress might occur if things are not in their particular way.
OCD vs OCPD: Explained
While the symptoms of both disorders are fairly similar, they can be distinguished by the patient’s awareness of their condition.
Patients with OCD, for instance, exhibit behavior that is ego-dystonic. Ego-dystonia exists when a patient is aware of their abnormal behavior and acknowledges that it’s the reason for their distress and self-defeating outcomes.
OCPD patients, on the other end, are fixated on the belief that their behavior is appropriate and a core part of their personality; this is known as ego-syntonic behavior.
Moreover, in OCD, patients feel distressed following abnormal behavior. While in OCPD, a temporary sense of pleasure and relief occurs after their compulsive behavior.
OCPD & Splitting
Splitting, or black-and-white thinking, is a defense mechanism commonly seen in personality disorders, including OCPD, borderline-PD, and narcissistic-PD. The defense mechanism causes an instability of thinking patterns, resulting in extremes of either ‘all good’ or ‘all bad.’
The presence of splitting, a sign of ego-syntonic behavior, occurs only in OCPD. This diagnostic marker can be utilized to establish if a patient is suffering from OCPD rather than OCD.
Both OCD and OCPD could impair daily functioning in areas of life such as social, occupational, and other areas as well.
Additionally, both disorders might cause instability in interpersonal relationships and increase the risk of social isolation, substance abuse, and suicide.
If you or someone you know may be suffering from OCD or OCPD, speak to a mental health professional. There are effective treatments to help alleviate symptoms: cognitive behavioral therapy and psychotropic medications.
Differences Between OCPD VS OCD
For many people around the world, suffering from certain disorders can negatively impact their daily lives.
Two conditions that are often confused with each other are obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD).
While both of these disorders sound the same, and there may be similar traits, they are considered and treated as two different disorders.
OCD VS OCPD
When trying to determine the difference between OCD versus OCPD, keep in mind that OCD is an anxiety disorder while OCPD is a personality disorder. When a person has OCD, they know that their thoughts or impulses are not reasonable behaviors.
The anxiety triggered from intrusive obsessions are often not real-life events. They recognize that the thoughts are irrational and excessive, yet have extreme difficulty controlling the urges to engage in subsequent compulsions to gain relief.
On the other hand, a person with OCPD wouldn’t think anything is wrong or obsessive with their thoughts or behaviors. They become so fixated with rules and lists in their daily life that they value and prioritize perfection over the bigger goal. Their symptoms often impair their relationships with coworkers, family and friends to the point where they become socially isolated.
A person with OCPD will often avoid treatment since they don’t believe there is anything wrong with how they think or behave, and typically only seek treatment when their job or personal relationships are threatened. Treatments can range from relaxation, medication and psychotherapy.
If you or a loved one suffer from OCD, the Renewed Freedom Center provides evidence-based treatment that is short-term with lasting benefits. We help children and adults manage OCD behaviors so that they can live fulfilling lives. Contact us today to learn more.