Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder: They’re Not the Same
What comes to mind when you hear the term “obsessive-compulsive”? Perhaps you think about a person who is driven or extremely preoccupied with order, or someone who engages in repetitive, senseless behaviors. It’s true that these behaviors are often characterized as obsessive and compulsive, but did you know that the term “obsessive-compulsive” is used to describe two very different emotional conditions?
OCD and OCPD: Counting the Ways They Differ
Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) are often mistaken for the same condition, but they are really quite different. They differ not only in symptoms, but also in severity and psychiatric category.
According to the American Psychiatric Association, OCD is an anxiety disorder (an unrealistic, irrational fear or anxiety of disabling intensity), whereas OCPD is a personality disorder (a chronic pattern of inflexible and distorted personality and behavioral patterns). Let’s take a closer look at these disorders.
Obsessive-Compulsive Disorder (OCD)
People with obsessive-compulsive disorder (OCD) experience repetitive thoughts and behaviors that make no sense.
Their obsessive thoughts may include:
- Persistent fears of harm coming to themselves or a loved one
- Unreasonable concern with being contaminated
- Intrusive and unacceptable religious, violent, or sexual thoughts
- Excessive need to do things correctly or perfectly
Their compulsive behaviors may include:
- Excessive checking of door locks, stoves, water faucets, light switches, etc.
- Repeatedly making lists, counting, arranging, or aligning things
- Collecting and hoarding useless objects
- Repeating routine actions a certain number of times until it feels just right
- Unnecessary rereading and rewriting
- Mentally repeating phrases
- Excessive washing, sometimes for hours every day
These obsessive thoughts and compulsive behaviors are extremely difficult for the person to overcome. If severe and untreated, OCD may destroy a person’s ability to function at work, at school, or at home. OCD may increase an individual’s risk of suicidal thoughts and probably suicide attempts, as well as completed suicide.
Treatment of OCD
OCD is commonly treated with behavior therapy and antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). Risk of suicide should be assessed and monitored in all persons diagnosed with and treated for this disorder.
Obsessive-Compulsive Personality Disorder (OCPD)
In contrast, people with OCPD do not have the same intense obsessions and compulsions as those with OCD. Rather, people with OCPD are perfectionists who tend to lack openness and flexibility in their daily routines, relationships, and expectations. As a result, they have difficulty incorporating new information into their lives and may take a long time to learn new tasks and behaviors. They may have difficulty making decisions. Their thinking tends to be black and white, and they frequently see their way of doing things as the only right way. It can be very difficult for them to express their warm emotions. As a result of their perfectionism, they may be prone to depression, guilt, anxiety, and physical or sexual dysfunction.
In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM-IV), OCPD is defined as "a chronic, pervasive pattern of inflexibility and preoccupation with orderliness, perfectionism, and interpersonal and mental control that impedes flexibility, openness, and efficiency."
The disorder begins in early adulthood and is characterized by four or more of the following behaviors:
- Preoccupation with details, rules, lists, order, organization, or schedules, to the extent that the major point of an activity is lost
- Perfectionism that interferes with the completion of tasks
- Excessive devotion to work and productivity (not accounted for by obvious financial need), at the expense of leisure activities and friendships
- Excessive conscientiousness, inflexibility, and scrupulousness about matters of morality, ethics, and values
- Inability to throw out worn or useless items, even when they have no sentimental value
- Reluctance in delegating tasks to others unless they agree exactly with his or her way of doing them
- View of money as something to be hoarded; a tendency to be stingy
- Rigidity and stubbornness
Treatment of OCPD
OCPD is usually treated with individual psychotherapy or counseling that focuses on helping people accept themselves, change inflexible thinking, and get more in touch with their feelings. Unlike OCD, medication is not usually prescribed for people with OCPD, although certain antidepressants, such as SSRIs, may be helpful for some. Hospitalization is rarely needed for people with OCPD, unless extreme stress results in compulsive behaviors that cause harm or lead to immobility.
Although both OCD and OCPD involve obsessive and compulsive behaviors, OCD is a more severe and disabling condition. Most people with OCD and OCPD lead relatively normal lives and have families, friends, and regular jobs.
American Psychiatric Association
Anxiety Disorders Association of America
Obsessive Compulsive Foundation
Canadian Mental Health Association
Canadian Psychiatric Association
Carson RC, Butcher JN, Mineka S. Abnormal Psychology and Modern Life. 11th ed. Boston, MA: Allyn and Bacon; 2000.
Diagnostic and Statistical Manual of Mental Disorders DSM-IV. Washington, DC: American Psychiatric Publishing, Inc; 1994.
Fact sheet: obsessive compulsive disorder. Mental Health America website. Available at: http://www.mentalhealthamerica.net/go/ocd/. Updated May 2008. Accessed August 13, 2008.
Last reviewed June 2008 by Theodor B. Rais, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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