Obsessive-Compulsive Personality Disorder in DSM-IV-TR
Obsessive-Compulsive Personality Disorder (OCPD) is a mental disorder listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). It is characterized by an excessive preoccupation with orderliness, perfectionism, and control, at the expense of flexibility, openness, and efficiency. This article provides an overview of OCPD, including its history, diagnostic criteria, and treatment options.
History
OCPD was first described by Freud in 1908 as a maladaptive personality type, and was later included in the first edition of the DSM in 1952. It was initially called “Compulsive Personality”, but this was changed in the DSM-III in 1980 to “Obsessive-Compulsive Personality” to better reflect the disorder’s symptoms. The DSM-IV-TR further refined the diagnostic criteria for OCPD in 2000.
Diagnostic Criteria
In the DSM-IV-TR, OCPD is defined as a pervasive pattern of preoccupation with orderliness, perfectionism, and control of one’s environment, at the expense of flexibility, openness, and efficiency. This pattern must be present in at least four of the following areas:
1. Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
2. Perfectionism that interferes with task completion (e.g. is unable to complete a project because his or her own overly strict standards are not met).
3. Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
4. Excessive conscientiousness, scrupulousness, and undue preoccupation with productivity.
5. Inability to discard worn-out or worthless objects even when they have no sentimental value.
6. Reluctance to delegate tasks or to work in a group.
7. Miserliness hoarding money and possessions.
8. Rigidity and stubbornness.
Diagnosis requires that the symptoms be present for a minimum of six months, and that they cause significant distress or impairment in functioning.
Treatment
Treatment for OCPD typically involves psychotherapy and medications. Cognitive-behavioral therapy (CBT) is commonly used to identify and modify maladaptive thoughts and behaviors, and to help the patient become more flexible and accepting of imperfection. Medications such as antianxiety medications and selective serotonin reuptake inhibitors (SSRIs) are sometimes used to help manage anxiety and depression, as well as to reduce obsessive-compulsive behaviors.
Conclusion
OCPD is a pervasive pattern of preoccupation with orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency. It is listed in the DSM-IV-TR, and is diagnosed based on eight criteria. Treatment typically involves psychotherapy and medications, and can be very effective in helping those with OCPD to manage their symptoms and lead more fulfilling lives.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Freud, S. (1908). Character and anal erotism. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 9, pp. 169-175). London: Hogarth Press.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613. doi:10.1046/j.1525-1497.2001.016009606.x