What comes to mind when you hear the term obsessive-compulsive? Perhaps you think about a person who is driven or extremely preoccupied with order, or someone who engages in repetitive, senseless behaviors. It is true that these behaviors are often characterized as obsessive and compulsive, but did you know that the term “obsessive-compulsive” is used to describe two very different emotional conditions?
OCD and OCPD: Counting the Ways They Differ
(OCD) and obsessive-compulsive personality disorder (OCPD) are often mistaken for the same condition, but they are really quite different. They differ not only in symptoms, but also in severity and psychiatric category.
According to the American Psychiatric Association, OCD is an anxiety disorder (an unrealistic, irrational fear or anxiety of disabling intensity), whereas OCPD is a
(a chronic pattern of inflexible and distorted personality and behavioral patterns). Let’s take a closer look at these disorders.
Obsessive-Compulsive Disorder (OCD)
People with obsessive-compulsive disorder (OCD) experience repetitive thoughts and behaviors that make no sense.
Their obsessive thoughts may include:
Persistent fears of harm coming to themselves or a loved one
Unreasonable concern with being contaminated
Intrusive and unacceptable religious, violent, or sexual thoughts
Excessive need to do things correctly or perfectly
Their compulsive behaviors may include:
Excessive checking of door locks, stoves, water faucets, light switches, etc.
Repeatedly making lists, counting, arranging, or aligning things
Collecting and hoarding useless objects
Repeating routine actions a certain number of times until it feels just right
Unnecessary rereading and rewriting
Mentally repeating phrases
Excessive washing, sometimes for hours every day
These obsessive thoughts and compulsive behaviors are extremely difficult for the person to overcome. If severe and untreated, OCD may destroy a person’s ability to function at work, at school, or at home.
OCD may increase an individual’s risk of
and probably suicide attempts, as well as completed suicide.
Treatment of OCD
OCD is commonly treated with behavior therapy and antidepressant medicines called
selective serotonin reuptake inhibitors
(SSRIs). Risk of suicide should be assessed and monitored in all persons diagnosed with and treated for this disorder.
Obsessive-Compulsive Personality Disorder (OCPD)
In contrast, people with OCPD do not have the same intense obsessions and compulsions as those with OCD. Rather, people with OCPD are perfectionists who tend to lack openness and flexibility in their daily routines, relationships, and expectations. As a result, they have difficulty incorporating new information into their lives and may take a long time to learn new tasks and behaviors. They may have difficulty making decisions. Their thinking tends to be black and white, and they frequently see their way of doing things as the only right way. It can be very difficult for them to express their warm emotions. As a result of their perfectionism, they may be prone to
, and physical or sexual dysfunction.
In the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders
, fourth edition (DSM-IV), OCPD is defined as "a chronic, pervasive pattern of inflexibility and preoccupation with orderliness, perfectionism, and interpersonal and mental control that impedes flexibility, openness, and efficiency."
The disorder begins in early adulthood and is characterized by four or more of the following behaviors:
Preoccupation with details, rules, lists, order, organization, or schedules, to the extent that the major point of an activity is lost
Perfectionism that interferes with the completion of tasks
Excessive devotion to work and productivity (not accounted for by obvious financial need), at the expense of leisure activities and friendships
Excessive conscientiousness, inflexibility, and scrupulousness about matters of morality, ethics, and values
Inability to throw out worn or useless items, even when they have no sentimental value
Reluctance in delegating tasks to others unless they agree exactly with his or her way of doing them
View of money as something to be hoarded; a tendency to be stingy
Rigidity and stubbornness
Treatment of OCPD
OCPD is usually treated with individual psychotherapy or counseling that focuses on helping people accept themselves, change inflexible thinking, and get more in touch with their feelings. Unlike OCD, medicine is not usually prescribed for people with OCPD, although certain antidepressants, such as SSRIs, may be helpful for some. Hospitalization is rarely needed for people with OCPD, unless extreme stress results in compulsive behaviors that cause harm or lead to immobility.
Although both OCD and OCPD involve obsessive and compulsive behaviors, OCD is a more severe and disabling condition. Many people with either OCD and OCPD can lead relatively normal lives and have families, friends, and regular jobs.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a