Obsessive-Compulsive Disorder vs. Obsessive-Compulsive Personality Disorder

1. Apparent similarity in both
OCPD and OCD
OCPD OCD
Onset: early Must have developed by early
adulthood (adolescence) as a
personality. The trait may be seen
earlier.
At any age as a mental disorder.
Usually, onset in early adulthood.
Course: chronic Stable and enduring Variable and fluctuate over time.
Mild severity may follow a stressor.
More severe chronic with wax and
wane. The most severe can be
persistent despite treatment.
Perfectionist Perfectionism as pervasive and
inflexible need to follow details,
rules, lists, order, or organization
Other than symmetry & order
(which resemble perfectionistic
trait), other OCD themes such as
contamination/washing, and
doubt/checking are often
experienced by pts (dominant
theme may change from time to
time). Not pervasive.
excessively engaged in certain
tasks
Excessive devotion to work.
The task is justified/rationalized
to improve efficiency, avoid failure
or uncertainty
Time spent on compulsion which is
non-productive. Instead, its main
goal is to neutralize anxiety caused
by the obsession. Magical
thinking connects the obsession
with compulsion.
Interpersonal problems Usually, the main reason that
brings them to seek treatment.
Arises because of the need to
control all aspect of the
environment (including family,
friends, etc)
Usually, seek treatment because
of the distress caused by
obsession/compulsion. The
interpersonal problem arises
secondary to OCS.
Treatment: prescribed with SSRI Often develops anxiety/depression
and thus was given SSRI.
Otherwise, they may receive just
anxiolytic or CBT/psychotherapy
during crisis/stress.
SSRI has anti-obsessional
property. Usually given in higher
dose for a longer time.
Aetiology: Anal stage fixation
(psychodynamic)
Overly strict parenting (including
toilet training) leads to a character
defect in which there is relentless
toil towards minimizing threatening
disorder through ever rigorous
control of the internal and external
environment.
The patient regressed to anal
phase and call forth associated
defence mechanism such as
isolation of affect, reaction
formation and undoing to deal with
anxiety.
Other feature: inability to discard
items that no longer has value
In addition, the patient also has
miserly spending style
Hoarding can be a symptom of
OCD or separate disorder (a
category under OCRD)
ZO