Obsessive-Compulsive Personality Disorder (OCPD)

What is obsessive-compulsive personality disorder (OCPD)?

Obsessive-compulsive personality disorder (OCPD) is a mental health condition that causes an extensive preoccupation with perfectionism, organization and control. These behaviors and thought patterns interfere with completing tasks and maintaining relationships.

People with OCPD have rigid beliefs and specific ways of doing different tasks. They don’t allow for any flexibility and are unable to compromise with others. People with OCPD often don’t realize their behavior and way of thinking are problematic.

OCPD is one of a group of conditions called “Cluster C” personality disorders, which involve anxiety and fear.

What is the difference between OCD and OCPD?

Even though they sound similar, obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD) are different conditions.

OCD is an anxiety disorder in which you have frequent unwanted and intrusive thoughts (obsessions) that cause you to perform repetitive behaviors (compulsions). Examples of compulsions include flipping a light switch a certain number of times or repeatedly washing your hands.

People with OCD usually are aware that the condition is causing their behavior and accept that they need professional help to treat it. People with OCPD usually have little, if any, self-awareness of their behaviors.

Who does obsessive-compulsive personality disorder (OCPD) affect?

Obsessive-compulsive personality disorder usually begins in your late teens or early 20s. It’s more common in adults whose highest education level is high school graduation or less.

OCPD is also more likely to affect people with the following mental health conditions:

• Anxiety disorders (24%), such as panic disorder and generalized anxiety disorder.
• Mood disorders (24%), such as bipolar disorder.
• Mild to moderate substance use disorders (12% to 25%).

How common is OCPD?

Studies suggest that OCPD is the most common personality disorder in the general population in the United States. It affects 3% to 8% of adults.

What are the symptoms of OCPD?

The main sign of obsessive-compulsive personality disorder is a pervasive preoccupation (obsession) with order, perfectionism, control and specific ways of doing things. These behaviors make it difficult to complete tasks and cause issues with relationships.

Symptoms of OCPD usually begin by early adulthood.

A person with obsessive-compulsive personality disorder (OCPD) may:

• Be preoccupied with and insist on details, rules, lists, order and organization.
• Have perfectionism that interferes with completing tasks.
• Have excessive devotion to work and productivity. This results in neglecting hobbies and spending less time with loved ones.
• Have excessive doubt and indecisiveness.
• Use extreme caution to avoid what they perceive to be failure.
• Be rigid and stubborn in their beliefs and ways of doing things.
• Be unwilling to compromise.
• Be unwilling to throw out broken or worthless objects, even if they have no sentimental value.
• Have difficulty working with others or delegating tasks unless they agree to do things exactly as the person wants.
• Frequently become overly fixated on a single idea, task or belief.
• Perceive everything as “black or white” (dichotomous thinking).
• Have difficulty coping with criticism.
• Over-focus on flaws in other people.

At a glance, people with OCPD usually appear confident, organized and high-achieving. Their exacting standards may even benefit them in certain jobs. However, their inability to compromise or change their behaviors usually negatively affects their relationships.

What causes obsessive-compulsive personality disorder?

Personality disorders, including obsessive-compulsive personality disorder, are among the least understood mental health conditions.

Researchers are still trying to figure out the exact cause of them, but they think personality disorders develop due to several factors, including:

• Genetics: Scientists have identified a malfunctioning gene that may be a factor in OCPD. Researchers are also exploring genetic links to aggression, anxiety and fear, which are traits that can play a role in personality disorders. People are also more likely to have OCPD if they have biological family members with personality disorders, anxiety or depression.
• Childhood trauma: One study revealed a link between childhood traumas, such as child abuse, and the development of personality disorders.

How is OCPD diagnosed?

OCPD can be difficult to diagnose, as most people with a personality disorder don’t think there’s a problem with their behavior or way of thinking.

When they do seek help, it’s often because of anxiety or depression due to the problems created by their personality disorder, such as losing their job or relationships, not the disorder itself.

When a mental health professional, such as a psychologist or psychiatrist, suspects someone might have obsessive-compulsive personality disorder, they often ask broad, general questions that won’t create a hostile, defensive environment. They ask questions that shed light on:

• Relationships.
• Work history.
• Reality testing.
• Impulse control.

Because a person suspected of having OCPD may lack insight into their behaviors, mental health professionals often work with the person’s family and friends to collect more information about their behaviors and history.

Mental health providers base a diagnosis of OCPD on the criteria for the condition in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

For a diagnosis of OCPD, the person must have a persistent pattern of preoccupation with:

• Order.
• Perfectionism.
• Control of themselves, others and situations.

This pattern is portrayed by four or more of the behaviors listed in the symptoms section.

How is obsessive-compulsive personality disorder treated?

In most cases, people with obsessive-compulsive personality disorder (OCPD) don’t believe their behaviors are problematic. However, they might seek help if another issue causes them distress.

Psychotherapy (talk therapy) is usually the treatment of choice for personality disorders. The goal of treatment is to help the person uncover the motivations and fears associated with their thoughts and behavior. In addition, they can learn to relate to others more positively.

Two specific types of psychotherapy that can help people with OCPD include:

• Psychodynamic therapy: This type of therapy focuses on the psychological roots of emotional suffering. Through self-reflection and self-examination, the person undergoing therapy looks into problematic relationships and behavior patterns in their life to better understand themselves and change how they relate to other people and their environment.
• Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of therapy. A therapist or psychologist helps them take a close look at their thoughts and emotions. They’ll come to understand how their thoughts affect their actions. Through CBT, someone with OCPD can unlearn negative thoughts and behaviors and learn to adopt healthier thinking patterns and habits.

While there’s currently no medication that can treat personality disorders, there’s medication for depression and anxiety, which people with OCPD may also have. Treating these conditions can make it easier to treat OCPD.

Can OCPD be prevented?

While you can’t prevent OCPD, many of the related problems might be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to the person’s life, family and friendships.

What is the prognosis for OCPD?

The prognosis (outlook) for OCPD depends on if it’s treated or not.

Left untreated, OCPD may result in:

• Poor relationships.
• Occupational difficulties.
• Impaired social functioning.

A note from Cleveland Clinic

It’s important to remember that obsessive-compulsive personality disorder (OCPD) is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Mental health professionals can offer treatment plans that can help you manage your thoughts and behaviors.

The loved ones of people with OCPD often experience stress, depression and isolation. It’s important to take care of your mental health and seek help if you’re experiencing these symptoms.