Obsessive–compulsive personality disorder

Not to be confused with Obsessive–compulsive disorder.

Obsessive–compulsive personality disorder
Classification and external resources
ICD-10	F60.5
ICD-9	301.4
MedlinePlus	000942
MeSH	D003193

Personality disorders
Cluster A (odd)
Paranoid · Schizoid Schizotypal
Cluster B (dramatic)
Antisocial · Borderline Histrionic · Narcissistic
Cluster C (anxious)
Avoidant · Dependent Obsessive-compulsive
Not specified
Depressive Passive–aggressive Sadistic · Self-defeating
v · personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.[1] Signs and symptoms The primary symptoms of OCPD can include preoccupation with remembering and paying attention to minute details and facts, following rules and regulations, compulsion to make lists and schedules, as well as rigidity/inflexibility of beliefs and/or exhibition of perfectionism that interferes with task-completion. Symptoms may cause extreme distress and interfere with a person's occupational and social functioning. [2][3]According to the National Institute for Mental Health: OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). However, people with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct.[4] Most patients spend their early life avoiding symptoms and developing techniques to avoid dealing with these strenuous issues. Obsession Some, but not all, patients with OCPD show an obsessive need for cleanliness. This OCPD trait is not to be confused with domestic efficiency; over-attention to related details may instead make these (and other) activities of daily living difficult to accomplish. Though obsessive behavior is in part a way to control anxiety, tension often remains. In the case of a hoarder, attention effectively to clean the home may be hindered by the amount of clutter that the hoarder resolves later to organize.[5] While there are superficial similarities between the list-making and obsessive aspects of Asperger's syndrome and OCPD, the former is different from OCPD especially regarding affective behaviors, including (but not limited to) empathy, social coping, and general social skills. Perception of own and others' actions and beliefs tend to be polarised (i.e., "right" or "wrong", with little or no margin between the two) for people with this disorder. As might be expected, such rigidity places strain on interpersonal relationships, with frustration sometimes turning into anger and even violence. This is known as disinhibition.[6] People with OCPD often tend to general pessimism and/or underlying form(s) of depression.[7][8][9] This can at times become so serious that suicide is a risk.[10] Indeed, one study suggests that personality disorders are a significant substrate to psychiatric morbidity. They may cause more problems in functioning than a major depressive episode.[11] Causes Research into the familial tendency of OCPD may be illuminated by DNA studies. Two studies suggest that people with a particular form of the DRD3 gene are highly likely to develop OCPD and depression, particularly if they are male.[12][13] Genetic concomitants, however, may lie dormant until triggered by events in the lives of those who are predisposed to OCPD. These events could include trauma faced during childhood, such as physical, emotional or sexual abuse, or other types of psychological trauma. Diagnosis DSM The Diagnostic and Statistical Manual of Mental Disorders fourth edition, (DSM IV-TR = 301.4), a widely used manual for diagnosing mental disorders, defines obsessive–compulsive personality disorder (in Axis II Cluster C) as:[14] A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts. It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. Criticism Since DSM IV-TR was published in 2000, some studies have found fault with its OCPD coverage. A 2004 study challenged the usefulness of all but three of the criteria: perfectionism, rigidity and stubbornness, and miserliness.[15] A study in 2007[16] found that OCPD is etiologically distinct from avoidant and dependent personality disorders, suggesting it is incorrectly categorized as a Cluster C disorder. WHO The World Health Organization's ICD-10 defines a conceptually similar disorder to obsessive–compulsive personality disorder called (F60.5) Anankastic personality disorder.[17] It is characterized by at least three of the following: feelings of excessive doubt and caution; preoccupation with details, rules, lists, order, organization or schedule; perfectionism that interferes with task completion; excessive conscientiousness, scrupulousness, and undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships; excessive pedantry and adherence to social conventions; rigidity and stubbornness; unreasonable insistence by the individual that others submit exactly to his or her way of doing things, or unreasonable reluctance to allow others to do things; intrusion of insistent and unwelcome thoughts or impulses. Includes: compulsive and obsessional personality (disorder) obsessive-compulsive personality disorder Excludes: obsessive-compulsive disorder It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. Millon's subtypes Theodore Millon identified five subtypes of compulsive.[18][19] Any individual compulsive may exhibit some or one of the following: conscientious compulsive—including dependent features puritanical compulsive—including paranoid features. bureaucratic compulsive—including narcissistic features parsimonious compulsive—including schizoid features. Resembles Fromm's hoarding orientation[20] bedeviled compulsive—including negativistic (passive-aggressive) features Differential diagnosis Obsessive–compulsive personality disorder is often confused with obsessive–compulsive disorder (OCD). Despite the similar names, they are two distinct disorders, although some OCPD individuals also suffer from OCD, and the two are sometimes found in the same family,[21] sometimes along with eating disorders.[22] People experiencing OCPD do not generally feel the need to repeatedly perform ritualistic actions—a common symptom of OCD—and usually find pleasure in perfecting a task, whereas OCD patients are often more distressed after their actions. Treatment Treatment for OCPD normally involves psychotherapy and self-help. However, in some cases, there can be an impediment to change in that the patient does not accept that they have OCPD, and/or believes (at least at some level) that their thoughts and/or behaviors are in some sense "correct" and therefore should not be changed. Medication in isolation is generally not indicated for this personality disorder, but fluoxetine has been prescribed with success.[citation needed] Anti-anxiety medication may reduce feelings of fear while SSRIs (anti-depressants) can ease frustration, reducing stubbornness and negative rumination.[citation needed] Psychotherapy Cognitive behavioral therapy Behavior therapy: Discussing with a psychotherapist ways of changing compulsions into healthier, productive behaviors. An effective form of this therapy[23] has been found to be cognitive analytic therapy.[24] Psychotherapy: Discussion with a trained counselor or psychotherapist who understands the condition. Psychopharmacology: A psychiatrist may be able to prescribe medication to facilitate self-management and also enable more productive participation in other therapies. Epidemiology Obsessive–compulsive personality disorder occurs in about 1 percent of the general population. It is seen in 3–10 percent of psychiatric outpatients. It is twice as common in males as females.[25] History In 1908, Sigmund Freud named what is now known as obsessive–compulsive or anankastic personality disorder "anal retentive character". He identified the main strands of the personality type as a preoccupation with orderliness, parsimony (frugality), and obstinacy (rigidity and stubbornness). The concept fits his theory of psychosexual development. Since the early 1990s, considerable new research continues to emerge into OCPD and its characteristics, including the tendency for it to run in families along with eating disorders[26] and even to appear in childhood.[27] See also Analysis paralysis References ^ Taber's Cyclopedic Medical Dictionary 18th ed 1968 ^ Taber's Cyclopedic Medical Dictionary 18th ed 1968 ^ http://www.psyweb.com/mdisord/jsp/ocpd.jsp ^ http://www.nlm.nih.gov/medlineplus/ency/article/000942.htm ^ Jefferys, Don (2008). "Pathological hoarding". Australian Family Physician 37 (4): 237–241. http://www.racgp.org.au/afp/200804/23717. Retrieved October 7, 2009.  ^ Villemarette-Pittman NR et al. (2004). Obsessive–compulsive personality disorder and behavioral disinhibition. Psychol. Jan: 138(1):5–22. ^ Pilkonis PA, Frank E. (1988). Personality pathology in recurrent depression: nature, prevalence, and relationship to treatment response. Am J Psychiatry. 145: 435–41 ^ Rossi A et al. (2000). Pattern of comorbidity among anxious and odd personality disorders: the case of obsessive–compulsive personality disorder. CNS Spectr. Sep; 5(9): 23–6. ^ Shea MT et al. (1992). Comorbidity of personality disorders and depression; implications for treatment. J Consult Clin Psychol. 60: 857–68. ^ Raja M, Azzoni A. (2007). The impact of obsessive–compulsive personality disorder on the suicidal risk of patients with mood disorders. Psychopathology. 40(3): 184–90 ^ Skodol AE et al. (2002). Functional Impairment in Patients With Schizotypal, Borderline, Avoidant, or Obsessive–Compulsive Personality Disorder. Am J Psychiatry 159:276–83. February. ^ Joyce et al. (2003). Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders. Psychiatry Research. 119(2):1–10. ^ Light et al. (2006). Preliminary evidence for an association between a dopamine D3 receptor gene variant and obsessive–compulsive personality disorder in patients with major depression. ^ Obsessive–compulsive personality disorder. Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000) ^ Grilo CM. (2004). Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder. Behaviour Research and Therapy 42(1) January,57–65. ^ Reichborn-Kjennerud T et al. (2007). Genetic and environmental influences on dimensional representations of DSM-IV cluster C personality disorders: a population-based multivariate twin study. Psychol Med. May; 37(5): 645–53 ^ Anankastic personality disorder. International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) ^ Millon, Theodore, Personality Disorders in Modern Life, 2004 ^ Millon, Theodore - Personality Subtypes ^ Fromm, E Man For Himself, 1947 ^ Samuels J et al. (2000). Personality disorders and normal personality dimensions in obsessive–compulsive disorder. Br J Psychiatry. Nov. 177: 457–62. ^ Mancebo MC et al. (2005). The relation among perfectionism, obsessive–compulsive personality disorder and obsessive–compulsive disorder in individuals with eating disorders. Int J Eat Disord. Dec; 38(4). ^ Protogerou et al. (2008). Evaluation of Cognitive-Analytic Therapy (CAT) outcome in patients with Obsessive–Compulsive Personality Disorder Annals of General Psychiatry 2008, 7(Suppl 1):S109 ^ Ryle, A. & Kerr, I. B. (2002) Introducing Cognitive Analytic Therapy: Principles and Practice. Chichester: John Wiley & Sons. ^ Internet Mental Health - obsessive–compulsive personality disorder ^ Lilenfeld et al. (1998). A Controlled Family Study of Anorexia Nervosa and Bulimia Nervosa. Arch Gen Psychiatry. 55:603–10. ^ Anderluh MB et al. (2003) Childhood obsessive–compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype. Am J Psychiatry. Feb. 160: 242–7. Further reading Baer, Lee. (1998). "Personality Disorders in Obsessive–Compulsive Disorder". In Obsessive–Compulsive Disorders: Practical Management. Third edition. Jenike, Michael et al. (eds.). St. Louis: Mosby. Freud, S. (1959, original work published 1908).Character and Anal Eroticism, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, 9, 170–1. James Strachey, ed. London: Hogarth. ISBN 978-0-7012-0067-1 ISBN 0-7012-0067-7 Jenike, Michael. (1998). "Psychotherapy of Obsessive–compulsive Personality". In Obsessive–Compulsive Disorders: Practical Management. Third edition. Jenike, Michael et al. (eds.). St. Louis: Mosby. Kay, Jerald et al. (2000). "Obsessive–Compulsive Disorder". In Psychiatry: Behavioral Science and Clinical Essentials. Jenike, Michael et al. Philadelphia: W. B. Saunders. MacFarlane, Malcolm M. (ed.) (2004). Family Treatment of Personality Disorders. Advances in Clinical Practice. Binghamton, NY: The Haworth Press. Penzel, Fred. (2000). Obsessive–Compulsive Disorders: A Complete Guide to Getting Well and Staying Well. Oxford University Press, USA. MPN 0195140923 Ryle, A. & Kerr, I. B. (2002). Introducing Cognitive Analytic Therapy: Principles and Practice. Chichester: John Wiley & Sons. ISBN 978-0-470-85304-7. Salzman, Leon. (1995).Treatment of Obsessive and Compulsive Behaviors, Jason Aronson Publishers. ISBN 1-56821-422-7 External links DSM IV-TR year 2000 criteria for OCPD MedlinePlus Encyclopedia Obsessive–compulsive personality disorder Wikimedia Foundation. 2010. Игры ⚽ Нужна курсовая? Compulsive Lyres Compulsory dance Look at other dictionaries: Obsessive-compulsive personality disorder — DiseaseDisorder infobox Name = Anankastic personality disorder ICD10 = ICD10|F|60|5|f|60 ICD9 = ICD9|301.4 Obsessive compulsive personality disorder (OCPD), or anankastic personality disorder, is a personality disorder that is characterized by a… …   Wikipedia obsessive-compulsive personality disorder — [DSM IV] a personality disorder characterized by an emotionally constricted manner that is unduly conventional, serious, rigid, stubborn, and stingy; by preoccupation with trivial details, rules, order, organization, schedules, and lists to the… …   Medical dictionary compulsive personality — obsessive compulsive personality disorder …   Medical dictionary Obsessive-compulsive disorder — (OCD) is a chronic anxiety disorder most commonly characterized by obsessive, distressing, intrusive thoughts and related compulsions. Compulsions are tasks or rituals which attempt to neutralize the obsessions. OCD is distinguished from other… …   Wikipedia Personality disorder — Classification and external resources ICD 10 F60 ICD 9 301.9 …   Wikipedia obsessive-compulsive disorder — n a psychoneurotic disorder in which the patient is beset with obsessions or compulsions or both and suffers extreme anxiety or depression through failure to think the obsessive thoughts or perform the compelling acts abbr. OCD called also… …   Medical dictionary Personality disorder not otherwise specified — Personality disorder, unspecified Classification and external resources ICD 10 F60.9 ICD 9 301.9 …   Wikipedia Obsessive–compulsive disorder — OCD redirects here. For other uses, see OCD (disambiguation). Not to be confused with Obsessive–compulsive personality disorder. Obsessive–compulsive disorder Classification and external resources Repetitive handwashing is a common OCD sym …   Wikipedia obsessive-compulsive — Having a tendency to perform certain repetitive acts or ritualistic behavior to relieve anxiety, as in o. neurosis ( e.g., a compulsive, ritualistic need to wash one s hands many dozens of times per day). * * * obsessive compulsive adj relating… …   Medical dictionary Self-defeating personality disorder — Personality disorders Cluster A (odd) Paranoid · Schizoid Schizotypal …   Wikipedia 18+ © Academic, 2000-2024 Contact us: Technical Support, Advertising Dictionaries export, created on PHP, Joomla, Drupal, WordPress, MODx. Mark and share Search through all dictionaries Translate… Search Internet Share the article and excerpts Direct link … Do a right-click on the link above and select “Copy Link”