Obsessive Compulsive (Anankastic) Personality Disorder Criteria

Beginning by early adult life, preoccupation with control, orderliness and perfection overshadow qualities of efficiency, flexibility and candor. These behaviors are present in a variety of situations and shown by at least 4 of:

Is absorbed with details, lists, order, organization, rules or schedules to such an extent that the purpose of the activity is lost ("can't see the forest for the trees").

Perfectionistic to a degree that interferes with completing the task.

Is a workaholic (works to exclusion of leisure activities).

to a degree out of keeping with cultural or religious influence, is overly conscientious, inflexible or scrupulous about ethics, morals or values.

Saves worthless items of no real or sentimental value.

Won't cooperate or delegate tasks unless others agree to do things the patient's way.

Is stingy toward self and others; hoards money against future need.

Is rigid and stubborn

DSM-IV Code: 301.4.

Associated Features:

Odd/Eccentric/Suspicious Personality

Differential Diagnosis:

Some disorders have similar or even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis.

Delusional Disorder.
Schizophrenia.
Mood Disorder With Psychotic Features.
Paranoid Personality Disorder.
Personality Change Due to a General Medical Condition.
Symptoms that may develop in association with chronic substance use.

Cause:

These are growing evidence that Obsessive Compulsive Disorder or OCD has a neurobiological basis. It is no longer attributed to family problems or to attitudes learned in childhood. Neuro scans show that patients with OCD have a set pattern of brain activity that differs from people with no mental illness.

Treatment:

There is no specific treatment; however, therapy or counseling may be of value.

Counseling and Psychotherapy [ See Therapy Section ]:

Short-term therapy will be most likely to be beneficial when the patient's current support system and coping skills are examined. Those skills which are not currently working could be reinforced with additional skill sets. Social relationships can also be examined, reinforcing strong, positive relationships while having the client re-examine negative or harmful relationships. One important aspect is to try and have the individual examine and properly identify their feeling states, rather than just intellectualizing or distancing themselves from their emotions. This can be accomplished through a variety of techniques, such as feeling identification (e.g., the "feeling faces") at the onset of every therapy session. Homework might include writing feelings down in a journal, especially as they notice them. Proper identification and realization of feelings can bring about much change in and of itself.

Individuals suffering from obsessive-compulsive personality disorder often are not in touch with their emotional states as much as their thoughts. Leading the client away from describing situations, events, and daily happenings and to talking about how such situations, events and daily happenings made them feel may be helpful. Sometimes the patient may complain he or she doesn't remember or know how he or she felt at the time; the journal becomes a useful tool at this point.

Pharmacotherapy [ See Psychopharmacology Section ] :

In most cases, medication for this disorder is not indictated unless the individuals is also suffering from a clearly delineated Axis I diagnosis as well. However, newer medications such as Prozac, an SRRI, have been approved for the treatment of obsessive-compulsive disorder and may provide some relief to individuals with the personality disorder. Long-term use, though, is rarely indicated, appropriate, or beneficialy.