What’s the difference between Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder?

Obsessive-compulsive disorder (OCD) and Obsessive-compulsive personality disorder (OCPD) are two psychiatric conditions marked with obsessive and compulsive behaviors, yet each disease is profoundly different in both terms of symptoms and severity level. While they share some similarities, such as excessive anxiety and obsessions, they bear marked differences in causation, treatment, and diagnosis.

What is Obsessive-compulsive disorder (OCD)?

OCD is a mental health condition characterized by the presence of repetitive, intrusive thoughts and urges that produce anxiety, so-called obsessions, and repetitive behaviors, known as compulsions, which help lessen the anxiety-producing obsessions.

Obsessions typically exhibit themselves in distressing, intrusive, and unreasonable ways, such as unwanted or taboo thoughts, concerns about cleanliness, fear of hurting oneself or others, fear of losing control, or preoccupations with symmetry and order. Compulsions, by contrast, are actions that individuals with OCD take to prevent or reduce anxiety caused by these obsessions, such as excessive hand-washing, checking, cleaning, or arranging objects.

OCD is a common condition, affecting more than 1% of people worldwide, and it can occur at any age, yet it typically comes on during teenage years or early adulthood.

What is Obsessive-compulsive personality disorder (OCPD)?

OCPD is a personality disorder characterized by an intense preoccupation with orderliness, perfectionism, and control, which interferes with flexibility, openness, and efficiency of functioning. Unlike OCD, OCPD is characterized by pervasive obsessions and compulsions affecting every area of life, rather than a specific thought or behavior pattern. People with OCPD tend to be rigid, overly conscientious, and excessively devoted to work, which can lead to workaholism or other forms of impaired functioning in daily life.

OCPD is a rare condition, affecting fewer than 1% of people worldwide, and it typically emerges in early adulthood or middle age.

Symptoms of OCD and OCPD

OCD and OCPD share some common symptoms, including rigid and inflexible thinking patterns, excessive concerns about orderliness and cleanliness, and spending a disproportionate amount of time on routine activities or changing minor details of a project. OCD and OCPD share symptoms of anxiety, as well, even though the underlying condition is different:

Symptoms of OCD

  • Recurrent, unwanted or intrusive thoughts, images, or urges that cause anxiety and distress.
  • Repetitive behaviors or mental acts performed in response to obsessive thoughts or according to strict rules or standards.
  • Attempts to ignore or suppress obsessions, or the overwhelming need to perform compulsive acts.
  • Anxiety, distress, or impairment in functioning caused by obsessions or compulsions.

Symptoms of OCPD

  • Performing tasks with an excessive concern for details, rules, or lists.
  • Exhibited inflexibility regarding moral, ethical, or personal values.
  • An over-preoccupation with work and productivity to the extent that personal relationships, leisure activities or exercise are ignored.
  • Perfectionism that causes tasks to be incomplete because of a foreshortened unrealistic amount of time.

Causes of OCD and OCPD

Both OCD and OCPD have unknown causes, and research suggests that genetics, environment, and brain chemistry can play a part in their development. OCD may run in families, and stressful or traumatic experiences can trigger the development of OCD. Resent research suggests that alterations in brain function, specifically in the ventromedial prefrontal cortex, the thalamus, and the striatum may play a part in the onset of OCD.

OCPD, by contrast, is rooted in a disapproving childhood environment, where parents were excessively rigid, perfectionistic, or criticized every accomplishment. Studies have shown that neuro-physiological differences may affect the development of OCPD, such as decreased activity in parts of the brain responsible for emotional processing, including the anterior cingulate gyrus.

Treatment for OCD and OCPD

Both OCD and OCPD are treated with psychotherapy, medication or a combination of both, yet the methods of treatment and the intensity of the condition can vary greatly.

Treatment for OCD

OCD is typically treated with a combination of Cognitive Behavioral Therapy (CBT) and possibly medication, such as anti-anxiety medications or antidepressants. CBT is a type of psychotherapy that helps individuals identify negative thinking patterns and behaviors and teaches them new, more adaptive ways of thinking and behaving to alleviate anxiety and distress. In some cases, exposure and response prevention (ERP) therapy, which involves exposing individuals to their feared situations in a controlled environment, may be helpful in teaching patients to tolerate anxiety without engaging in compulsive behaviors.

Treatment for OCPD

OCPD treatment typically involves psychotherapy, such as CBT or psychodynamic therapy, to help individuals learn new coping skills and improve social skills. In some cases, medication, such as antidepressants or antianxiety medication, may be used to alleviate anxiety or other related symptoms. However, it is important to note that OCPD is resistant to treatment and can take years of dedication and persistence on the part of both the patient and therapist to achieve results.

Conclusion

In conclusion, while OCD and OCPD may exhibit similar symptoms, such as obsessions and compulsive behaviors, their causation, symptoms, severity, and treatment differ significantly. Understanding the fundamental differences between OCD and OCPD, as well as the ways in which these conditions can be treated, can empower individuals, family members, and mental health providers to make informed choices and, ultimately, lead to a better treatment outcome.

FAQs

FAQs About What’s The Difference Between Obsessive Compulsive Disorder And Obsessive Compulsive Personality Disorder

Q: What are the key differences between obsessive compulsive disorder (OCD) and obsessive compulsive personality disorder (OCPD)?

A: OCD is a mental health condition characterized by recurrent, unwanted thoughts or obsessions, often followed by repetitive behaviors or compulsions. On the other hand, OCPD is a personality disorder marked by a pervasive pattern of inflexibility, perfectionism, and preoccupation with orderliness, at the expense of flexibility, openness, and enjoyment in life. While both conditions share some common traits, they differ in terms of their severity, impact on daily life, and treatment approach.

Q: Can people with OCD and OCPD both have obsessions and compulsions?

A: Yes, both OCD and OCPD involve patterns of compulsive behavior and rigid thinking. However, the nature and frequency of these behaviors can vary. For example, people with OCD may engage in repeated hand-washing, while individuals with OCPD may feel compelled to organize their possessions in a certain way. Additionally, people with OCD typically experience distress and anxiety related to their obsessions, while those with OCPD may not find their behavior problematic at all.

Q: How are OCD and OCPD treated?

A: Treatment approaches for OCD and OCPD can differ, depending on the severity and nature of each condition. Cognitive-behavioral therapy (CBT) is often used to treat OCD, with a focus on exposure and response prevention techniques to help patients manage their obsessions and compulsions. Medications such as selective serotonin reuptake inhibitors (SSRIs) may also be prescribed. OCPD treatment, on the other hand, typically focuses on addressing the patient’s rigidity, perfectionism, and lack of emotional expression through therapy and self-help strategies.


References

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

2. Tolin, D. F., Abramowitz, J. S., & Diefenbach, G. J. (2005). Defining Obsessive-Compulsive Personality Disorder: A Comparison of Guidelines, Dimensional Models, and Diagnostic Criteria. Journal of Personality Assessment, 84(3), 232–242. doi: 10.1207/s15327752jpa8403_02

3. Fineberg, N. A., & Gale, T. M. (2005). Evidence-Based Pharmacotherapy of Obsessive-Compulsive Disorder. International Journal of Neuropsychopharmacology, 8(1), 107–129. doi: 10.1017/s1461145704004762