Having obsessive compulsive personality traits usually helps people do well in some occupations that demand orderliness and precision. However, having obsessive compulsive personality disorder greatly interferes with peoples’ overall functioning.

People with obsessive compulsive personality disorder are perfectionists and try to exercise a rigid control over themselves and others. They become angry or withdrawn when other people interfere with their rigid routines or if they feel they are not in control of a specific situation. Spontaneity is frowned on, and they keep tight control over their emotions. Inflexibility and the inability to delegate work may seriously prevent them from career advancement. Money is typically tightly held, and they may be quite frugal, even miserly.

In the DSM IV TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision), obsessive compulsive personality disorder is classified as a Cluster C Personality Disorder (personalities typifying fearful people) and is defined as a pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency. There is preoccupation with details, rules, lists, organization or schedules to the extent that the major point of the activity is lost; perfectionism interferes with task completion (e.g., inability to complete a project because their own overly strict standards are not met); they are excessively devoted to work and productivity to the exclusion of leisure activities; patients are scrupulous and inflexible about matters of morality, ethics or values; they are unable to discard worthless objects even when they have no sentimental value and are reluctant to delegate tasks or to work with others unless they submit to exactly their own way of doing things; affected people sometimes adopt a miserly spending style and show rigidity and stubbornness.

Obsessive compulsive personality disorder starts in teenage years, has a lifetime prevalence of 1% and is more common in males than in females. The course of the disease is chronic, and it is thought to be caused by a combination of genetic and environmental factors. This disorder is often found in fundamentalist groups of any religion, where strict rule-adherence is paramount.

Obsessive compulsive personality disorder must be distinguished from obsessive compulsive disorder, which is classified as an anxiety disorder and is defined by the presence of obsessions and compulsions. Patients with obsessive compulsive disorder are no more likely to also have obsessive compulsive personality disorder than any other personality disorder.

Psychotherapy (individual, group or family) is considered the most effective treatment for this type of personality disorder. It involves talking about the symptoms, gaining insight into the condition and learning healthy ways to manage it. One difficulty encountered in therapy is the powerful need that patients feel to control both the therapy and the therapist. Medications (e.g., selective serotonin reuptake inhibitors) can be effective in some cases. Early detection and intervention help improve the quality of life and productivity of those affected by obsessive compulsive personality disorder.

By Ana C Posada Diaz, M.D., Psychiatrist