OCD vs. Obsessive Compulsive Personality Disorder

Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) are often a source of considerable confusion for researchers, healthcare professionals, and patients. Despite having similar names and symptoms, OCD and OCPD are distinct forms of mental illness that have unique and specific characteristics. The main difference is that OCD is designated in the DSM within its own category called Obsessive-Compulsive and related disorders, while OCPD is considered a personality disorder.

OCD is a disorder defined as the presence of an obsession (an irrational thought or idea that continually repeats) or a compulsion (an irrational behavior performed repeatedly). These behaviors can occur together or on their own, and interfere with a person's quality of life and ability to function.

Obsessions are not simply worries about real, everyday problems; they are defined by specific clinical characteristics, namely:

• Irrational thoughts, images, or ideas that won’t go away, are unwanted and cause extreme distress
• Thoughts that you accept as your own but seem impossible to control
• Thoughts that are distressing enough to cause you to act in ways to actively dispel those thoughts, such as engaging in compulsive behaviors as a means of distraction

Similar to obsessions, compulsions are neither routines nor addictions. Rather, they are characterized by abnormal behaviors that may include:

• Irrational and often ritualistic behaviors you feel you must carry out over and over again, such as cleaning, hand-washing, counting, tapping, or double-checking
• Engaging in repetitive behaviors for fear that something terrible may happen, such as getting an infection
• Hoarding things out of fear that something bad may happen if you don't have these items near you
• Performing ritualistic behaviors to dispel anxieties about an obsessive thought, such as the fear of someone dying
• Repetitive behaviors that you recognize are irrational but find impossible to stop

OCPD is a personality disorder defined by strict adherence to orderliness and control over one's environment at the expense of flexibility and the openness to new experiences.

OCPD is characterized by personality traits such as:

• An excessive need for perfection and a relentless control over not only your environment but the nature of interpersonal relationships
• A preoccupation with details, rules, lists, and order to the extent that you may miss the major objective of an activity
• An excessive devotion to work at the expense of family or friends
• A rigidity and inflexibility with regards to morals, ethics, values, and/or the adherence to rules
• The inability to get rid of items that no longer have value (hoarding)
• The inability to be generous to others

While there is considerable overlap between the two disorders, there are four basic ways to tell OCD and OCPD apart:

• OCD is defined by the presence of true obsessions and/or compulsions. Conversely, with OCPD, the behaviors are not directed by thoughts you are unable to control or irrational behaviors you repeat over and over again, often with no apparent aim.
• Persons with OCD are typically distressed by the nature of their behaviors or thoughts, however much they are unable to control them, while people with OCPD fully believe that their actions have an aim and purpose.
• Persons with OCD will often seek professional help to overcome the irrational nature of their behavior and the persistent state of anxiety they live under. (Some, however, may not see their actions as irrational and will not seek help for behavior they believe to be helpful or necessary.)
• Persons with OCPD will usually not seek help because they don't see that anything they are doing is particularly abnormal or irrational.
• The symptoms of OCD tend to fluctuate in association with the underlying anxiety. Because OCPD is defined by inflexibility, the behaviors tend to be persistent and unchanging over the long term.

While there are clear conceptual differences between OCD and OCPD, in practice, these disorders can be difficult to tell apart. In some cases, a person may even be affected by both disorders.

To come to an informed diagnosis and find appropriate treatment, it is important to seek the care of a qualified mental health professional, such as a psychiatrist or psychologist. Some OCD and/or OCPD sufferers may not recognize the detrimental impact of their behavior(s) and may be in harm's way. If you know someone in this situation, encourage them to seek professional help in a supporting, sensitive way.