- Obsessive-compulsive personality disorder
Name = Anankastic personality disorder
ICD10 = ICD10|F|60|5|f|60
ICD9 = ICD9|301.4
Obsessive-compulsive personality disorder (OCPD), or anankastic personality disorder, is a
personality disorderthat is characterized by a general psychological "inflexibility", rigid conformity to rules and procedures, perfectionism, moral code, and/or "excessive" orderliness.
Obsessive compulsive personality disorder (OCPD) is often confused with
obsessive-compulsive disorder(OCD). This could be due to the more commonly known OCD and the similarities in name of the two disorders, however the mindsets are typically different and unrelated.
Those who are experiencing OCPD do not generally feel the need to repeatedly perform ritualistic actions - a common symptom of OCD. Instead, people with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things are not "right."
People with OCPD may try to rid themselves of excess energy when anxious or excited by twitching or doing unpredictable things. They may
hoard moneyfor future use, keep their home perfectly organized, or be anxious about delegatingtasks for fear that they won't be completed correctly. There are four primary areas that cause anxiety for OCPD personalities: time, relationship, uncleanliness, and money. There are few moral 'grey' areas for a person with fully developed OCPD; actions and beliefs are either completely right, or absolutely wrong. As might be expected, interpersonal relationships are difficult because of the excessive demands placed on friends, romantic partners and children. Persons with OCPD often have a negative outlook on life ( pessimism).
Diagnostic criteria (DSM-IV-TR)
DSM-IV-TR, a widely-used manual for diagnosing mental disorders, defines that for a patient to be diagnosed with obsessive-compulsive personality disorder, they must exhibit "at least four" of the following traits: [cite web
title = Obsessive-Compulsive Personality Disorder @ BehaveNet
publisher = BehaveNet Clinical Capsules
url = http://www.behavenet.com/capsules/disorders/o-cpd.htm
accessdate = 2008-07-06]
* Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
* Showing 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)
* Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
* Being overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
* Inability to discard worn-out or worthless objects even when they have no sentimental value
* Reluctance to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
* Adopting a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
* Shows rigidity and stubbornness
It is important to note that while a person may exhibit any or all of the characteristics of a personality disorder, it is not diagnosed as a disorder unless the person has trouble leading a normal life due to these issues.
Sigmund Freudwas the first person to characterize what is now known as obsessive-compulsive or anankastic personality disorder as the anal-retentive character. This fixationfit into his theory of psychosexual development.
Treatment for OCPD normally involves
psychotherapyand self help. Medication is generally not indicated for this personality disorder in isolation, but Fluoxetinehas been prescribed with success. Anti-anxiety medication will reduce the feeling of fear and SSRIs can replace the chronic frustration with a sense of well-being, as well as reducing stubbornness and negative rumination. A mild tranquilizercan reduce alcohol dependence, if present. ADD medication can improve task completion by improving mental focus, which will provide visible success and improve outlook for recovery. Caffeinesensitivity may be an exacerbating factor.
Behavior therapy— Talking with a psychotherapistabout ways to change compulsions into healthier, productive actions.
*Psychotherapy — Talking with a trained counsellor or psychotherapist who understands the condition.
Pharmacotherapy- A psychiatristcan prescribe medications which may make self-management and participation in other therapies possible and/or more productive.
*Educating family and friends about the condition will help them to manage behavioral problems more sympathetically, and to watch out for the warning signs.
*Support groups may also be helpful in accepting and changing obsessive-compulsive behaviors.
meditation, exercise, regular sleep, and a balanced diet are all important factors in maintaining this focus.
*Consult your healthcare provider if you are having difficulty sleeping and/or you are experiencing problems that prevent you from exercising regularly.
diarymay help the individual to identify those stressful situations that help to trigger compulsive reactions, enabling them to focus on more constructive activities.
*Retained items, the result of
hoarding, should be released, simultaneously reducing the shame associated with hoarding. Having an assistant to hoarded, collected, and stored items will facilitate the process.
* Salzman, Leon. "Treatment of Obsessive and Compulsive Behaviors",
Jason AronsonPublishers, 1995. ISBN 1-56821-422-7
* Shapiro, David. "Autonomy and Rigid Character", Basic Books, 1984. ISBN 0-465-00568-3
* Shapiro, David. "Neurotic Styles", Basic Books, 1965. ISBN 0-465-09502-X
* Penzel, Fred. "Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well"
* [http://www.ocdonline.com/articlephillipson6.php "Obsessive-compulsive personality disorder: A Defect of Philosophy, not Anxiety"] Article about the characteristics of OCPD by Steven Phillipson
* [http://www.nlm.nih.gov/medlineplus/ency/article/000942.htm Obsessive-compulsive personality disorder] Article on [http://medlineplus.gov/ MedlinePlus.gov] 's Medical Encyclopedia
* [http://www.schrodingers-cat.org/dd/ocpd.htm Cluster C: The Obsessive-Compulsive Personality Disorder (OCPD)] Article by Sharon C. Ekleberry discussing OCPD characteristics, manifestations, and treatment.
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