Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder (OCPD) often presents in the teen years and early 20s. Individuals with OCPD often exhibit perfectionism to an extent that any deviation from perceived perfection can lead to significant distress³ or frustration, severely impacting their personal and professional relationships. They may be goal-oriented and high achievers but become frustrated or hostile if other people interfere with the rigid rules or routines they have established for themselves and others. 

In relationships, people with obsessive-compulsive personality disorder may be preoccupied with a sense of control. They may outwardly try to control their partners’ behavior or appearance or withdraw emotionally if they believe their partner is not adhering to their standards. 

People with OCPD may also struggle at work. Although they may be high-performing and hardworking, they may become so fixated on perfection that they struggle to finish a task in an allotted timeframe. They may also struggle to maintain friendly work relationships, as they may be controlling or domineering.

To be diagnosed with obsessive-compulsive personality disorder based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, an individual must present with four of the listed symptoms.

General symptoms of OCPD include the following: 

• A rigid or stubborn personality 
• A lack of generosity
• Extreme difficulty showing affection
• Preoccupation with rules, details, lists, and order
• Excessive doubt and indecision
• Not wanting to delegate tasks for fear others will do it “wrong”
• Fixating on the flaws in other people
• Difficulties in relationships
• Black-and-white thinking (also known as all-or-nothing thinking)
• Hoarding objects, even if they are broken or have no sentimental value
• Excessive devotion to productivity or work
• Difficulties working with others 
• Extreme fear of failure
• Difficulty with compromise

People with Obsessive-compulsive personality disorder may have little to no self-awareness of the drawbacks of their symptoms and the ways they may be negatively impacting their lives and relationships.

Although there may be no singular cause for obsessive-compulsive personality disorder (OCPD), researchers have found that, like other personality disorders, OCPD may be caused by a combination of genetic and environmental factors.

Genetics

Scientists perform continual research to identify potential genetic components of OCPD and other personality disorders. So far, one malfunctioning gene has been linked to obsessive-compulsive personality disorder, though more research is needed to understand the connection fully. Additionally, individuals who have a family history of anxiety, depression, or personality disorders are more likely to develop a personality disorder themselves.

Childhood trauma

Studies indicate that childhood trauma, such as child abuse, can lead to the development of personality disorders. Research shows that verbal abuse can increase a child’s odds of developing a personality disorder such as OCPD, narcissistic personality disorder, borderline personality disorder, or paranoid personality disorder in adulthood. 

Mental health conditions

People with anxiety disorders, mood disorders, and substance use disorders are more likely to be affected by obsessive-compulsive personality disorder.

Personality factors

An individual who is sensitive to light, noise, texture, and other stimuli may also be more likely to develop a personality disorder. Research shows that in some cases, sensitive or “reactive” children are more likely to develop anxious or fearful personalities, which may also increase the likelihood of developing OCPD.

Diagnosing and treating obsessive-compulsive personality disorder (OCPD) can be difficult because people with OCPD may not see their thinking and behaviors as problematic. Often, when individuals with OCPD seek help, they may seek support for depression or anxiety instead of OCPD. 

To be diagnosed with OCPD, an individual must have a preoccupation with:

• Order
• Control (of themselves or others)
• Perfectionism

Other treatment options for obsessive-compulsive personality disorder

OCPD is a personality disorder. Some personality disorders can cause severe suicidal thoughts and ideation. In these cases, short-term hospitalization may be required. However, there are no specific, unique treatments for OCPD outside of RO-DBT and therapy. 

Though there is no FDA approved medication for OCPD, people with OCPD who have co-occurring mental health conditions such as depression or anxiety may benefit from medications for those conditions. Treating anxiety and/or depression may make it easier to treat or cope with OCPD. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition or symptom. This information is not a replacement for medical advice or diagnosis, the process of determining which disease or condition explains a person's symptoms and signs. 

Self-care

As with any mental health condition, prioritizing self-care can create a solid foundation for improving the symptoms of OCPD. Getting enough sleep, eating a nutritious diet, and implementing regular exercise into your daily routine are all effective ways to bolster mental health.

Living with a mental health condition can be challenging. If you have obsessive-compulsive personality disorder, you are not alone, and there are resources available to you. 

Therapy can be a valuable option for anyone struggling with a mental health condition, including obsessive-compulsive personality disorder. Working with a therapist can allow you to find new tools to cope with your symptoms and improve daily functioning, like work performance, relationships, and schooling. 

If you’re new to therapy, you may be unsure if it would fit you. Online therapy through a platform like BetterHelp may be a convenient option for individuals who lead busy lives or want to avoid long commutes and waiting room times. Online therapy offers the same effective treatment interventions as in-person therapy from the comfort of your home.

Support groups and online educational and supportive content may also be helpful for people with this condition. OCPD Online is a comprehensive resource for anyone who has OCPD, suspects they have obsessive-compulsive personality disorder, or is close to someone with the disorder. The website offers links to support groups and additional information about the condition. Additionally, this fact sheet on OCPD—republished by the National Library of Medicine—provides information on the symptoms and causes of the disorder. It also lists the diagnostic criteria for OCPD as laid out in the Diagnostic and Statistical Manual of Mental Disorders.

If you live with an individual who has OCPD, you may find yourself struggling to cope with some of the individual’s rules, preferences, or other thoughts and behaviors related to OCPD. You may also benefit from seeking support in the form of therapy or support groups if you are in this position.

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Recent research on obsessive-compulsive personality disorder has focused on the way people with the disorder are able to connect with others. Studies show connection tends to be a struggle for people with obsessive-compulsive personality disorder and that hostility or over-submissiveness in social groups tends to accompany obsessive-compulsive personality disorder. Understanding this factor allows researchers to focus on therapeutic interventions that target these specific social issues, which may help people with the disorder receive more effective treatment in the future.

Research is also being done on the health outlooks for people with OCPD. At this time, little is known about the connection between obsessive-compulsive personality disorder and long-term health. However, because the disorder is associated with perfectionism, higher levels of stress could be present for people living with this condition. A recent study on people with obsessive-compulsive personality disorder confirmed this hypothesis, noting that OCPD appears to have an impact on the cardiovascular health of people of all genders. This research underscores the importance of effectively treating OCPD.

Below are several critical statistics on obsessive-compulsive personality disorder:

• OCPD is more likely to affect people with other mental health conditions, such as anxiety disorders, mood disorders, and those with substance use disorders.
• OCPD is the most common personality disorder in the United States, affecting between 1.9% and 8% of adults. 
• Males are diagnosed with OCPD twice as often as females.
• OCPD is significantly less common in younger adults versus older adults.
• RO-DBT has been associated with 23% remission rates after treatment.