OCD vs. OCPD: What Are the Differences?

Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) are two different conditions. OCD is a mental health condition that involves obsessive, intrusive, and repetitive thoughts that make you feel compelled to repeat behaviors. OCPD is a personality disorder that involves being excessively focused on order and perfection.

This article will go over how OCD and OCPD are different. You will learn the symptoms of OCD and OCPD, as well as how these mental health conditions are diagnosed and treated.

Symptoms of OCD vs. OCPD

The symptoms of OCD and OCPD can overlap. People with either condition can have similar thought patterns and behaviors—for example, focusing on order, perfectionism, and organization. There are also some signs and symptoms of OCD that do not occur in OCPD.

OCD Symptoms

A person with OCD has true obsessions and compulsions, which are time-consuming and cause distress. OCD is classified as an anxiety disorder.

• OCD obsessions can be repeated thoughts, worries, or even mental images that are intrusive, unwanted, and unrelenting.
• OCD compulsions are repeating behaviors that a person feels driven or urged to do—usually, to avoid anxiety or perceived risk. For example, excessive hand washing to avoid the risk or fear of germs.
  

OCPD Symptoms

OCPD is a personality disorder. It looks and feels different than OCD. People with OCPD are strongly focused on—even obsessed with—a goal of perfection for themselves and others. They relentlessly maintain rules and order in their environment.

People with OCPD often:

• Are high-achieving, conscientious, and function well at work
• Have challenges understanding others' points of view
• Have difficulty hearing constructive criticism
• Look for patterns of control and order
• Desire perfectionism to the point that the urge gets in the way of them completing tasks
• Have tendencies toward being unable to throw away old or valueless objects

Causes of OCD and OCPD

The causes of both OCD and OCPD are not fully understood, but there are several factors that may contribute to a person's risk of having either condition.

OCD Risk Factors

• Brain: OCD might be related to poor communication between parts of the brain. Some studies have suggested that problems with neurotransmitters like serotonin could play an important role in OCD.
• Genetics: Studies have shown there is a genetic component to OCD. People with a family history of OCD are more likely to have the condition themselves.
• Stress and environment: A brain injury, infection, trauma, and stressful events can make a person more likely to develop OCD. Stress can both lead to and worsen the symptoms of OCD.
• Infections: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a reaction to the bacteria that causes strep throat. It usually happens in childhood. Inflammation in the brain related to a strep infection may contribute to a child developing OCD.

OCPD Risk Factors

• Genetics: OCPD appears to have a genetic component. Studies have shown that OCPD is more likely to occur in people who have a family history of the condition.
• Early attachment: One study found that OCPD may begin in childhood if there are disruptions to attachment bonds. For example, if a child is unable to form a bond with a primary caregiver, it can affect their later relationships. A personality disorder like OCPD can happen if a child is trying to cope without healthy attachment.

Diagnosis

Both OCD and OCPD are diagnosed by mental health professionals using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

How OCD Is Diagnosed

To diagnose OCD, a clinician will use the DSM-5 to determine the following:

• Obsessions or compulsions (or both) are present.
• The obsessions and/or compulsions are occurring because the person is trying to prevent anxiety, distress, or a situation they see as a risk.
• The obsessions and/or compulsions are excessive, and the thoughts and/or behaviors are taking up a lot of time in a person’s life (more than one hour a day) or causing them distress.
• The obsessions and/or compulsions make it hard for the person to function socially or at work.

Diagnosing OCPD

To diagnose OCPD, a clinician will use the DSM-5 to see if a person has the following traits:

• A constant pattern of order and control that may come at the expense of flexibility, efficiency, and openness.
• Perfectionism may interfere with their ability to complete a task, especially when the person’s standards are not being met.
• A preoccupation with details, rules, order, organization, and schedules exist to an extreme degree.
• There is an excessive devotion to work beyond their financial need, even forsaking personal relationships in favor of work.
• There are significant challenges with flexibility when it comes to their ideas and plans for completing tasks.

Treatment

Medication, talk therapy, or a combination of both can be useful for treating OCD and OCPD.

OCD Treatment

People with OCD can be prescribed a type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs). These medications have been shown to help treat OCD and they are often the first-line treatment for the condition.

Different kinds of psychotherapy can also be used to treat OCD, including:

• Cognitive behavioral therapy (CBT): CBT helps people understand how their thoughts (especially the negative ones) influence their behavior. They also learn strategies that can help them react differently to their thoughts.
• Exposure and response prevention (ERP): ERP exposes a person with OCD to the triggers causing their obsessions. Then, the therapy helps them overcome the need to do their compulsions.

OCPD Treatment

Treatment for OCPD has not been well-researched. Only a few small studies have been done. There are no specific medications for OCPD, but the same medications that help treat OCD (SSRIs) can also help some people with OCPD.

Small studies have suggested that CBT may also help some people with OCPD because it can teach them to examine their thoughts and actions.

Preventing OCD and OCPD

Since biological factors like genetics are a known component of OCD and OCPD, it's not necessarily possible to prevent these conditions.

However, there might be some interventions that can reduce the effect of a person's environment on their risk for developing OCD or OCPD. Early intervention can also help reduce the severity of the conditions.

Education and improving access to effective treatments can help people with any mental health condition.

Coping With OCD and OCPD

People with OCD are frequently distressed by the excessive and repeating thoughts and behaviors they experience. It can be time-consuming to repeat behaviors and can negatively affect a person's social functioning. OCD behaviors can also affect a person's friends, family, partners, and coworkers.

There are support groups for people with OCD as well as the people in their lives who want to help them. Some people with OCD find it relieving and empowering to talk to others who understand what they're going through.

Many people with OCPD do not know they have a disorder and may not be aware of how it is affecting the people around them. As such, people with OCPD may not reach out for help or even realize that help is available.

Summary

OCD and OCPD have similar names but they're not the same condition. OCPD is a personality disorder and OCD is an anxiety disorder.

Both OCD and OCPD can be diagnosed by a mental health professional using the criteria in the DSM-5. Depending on a person's needs, OCD and OCPD can often be treated with medications like SSRIs and therapy.

While a person with OCD is often distressed by their behaviors and thoughts, a person with OCPD may not be aware of the negative effect their behaviors are having on their life or the lives of those around them.