OCD vs OCPD

This past week, I watched the classic 1968 film, The Odd Couple, an archetype of Obsessive-Compulsive Personality Disorder (OCPD) according to Movies and Mental Illness: Using Films to Understand Psychopathology. I’ve heard about the distinctions between OCPD and a related disorder, Obsessive-Compulsive Disorder (OCD), but never felt like I fully understood it. Here’s what I found out:

The DSM-5 notes that one of the best ways to distinguish OCD from OCPD is to determine if true obsessions and compulsions are present. Their presence is required for an OCD diagnosis but not an OCPD diagnosis (American Psychiatric Association, 2013). I envision that when symptoms are accompanied by magical thinking, order/symmetry obsessions are easier to discern from the overvalued order found in OCPD; however, in the absence of magical thinking, symptom distinctions become more difficult to assess.

A fact sheet published by the International OCD Foundation recommends two other domains to consider: insight and interpersonal relationships. Although insight varies widely (and DSM-5 includes specifiers to denote it), those with OCD recognize that their unwanted thoughts are unreasonable to some extent. In OCPD, individuals hold strong convictions to their self-imposed rules and rigidity, believing that these rules truly are the best way to operate. Understandably, these convictions can interfere with interpersonal relationships. In work settings, an individual with OCD may find that symptoms interfere with task performance. However, an individual with OCPD may find that excessive devotion to work and fixation with details does not interfere with task performance as much as it does with their coworkers.

Research on OCPD is increasing in popularity but still rather limited to date. Some studies have proposed a subtype of OCD comorbid OCPD (Garyfallos et al., 2010), a comorbidity that may impact treatment response (Pinto, Liebowitz, Foa, & Simpson, 2011).

As studies on OCPD gain popularity, I hope broader understanding of OCPD's distinctiveness from OCD will increase as well.

-Mac

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Garyfallos, G., Katsigiannopoulos, K., Adamopoulou, A., Papazisis, G., Karastergiou, A., & Bozikas, V. P. (2010). Comorbidity of obsessive–compulsive disorder with obsessive–compulsive personality disorder: Does it imply a specific subtype of obsessive–compulsive disorder?. Psychiatry research, 177(1), 156-160.

Pinto, A., Liebowitz, M. R., Foa, E. B., & Simpson, H. B. (2011). Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder. Behaviour research and therapy,49(8), 453-458.