Aug 21st 2023
OCD and OCPD are similar in certain ways but are different conditions. OCD is characterized by intrusive thoughts which prompt sufferers to perform ritualized compulsions to alleviate feelings of anxiety and stress.
OCPD, however, is a personality disorder that causes sufferers to feel preoccupied with orderliness, perfectionism, and control. Their behavior is driven by a desire for order and efficiency, rather than obsessions and anxiety.
This article will explore the similarities and differences between OCP and OCPD by going over the symptoms, causes, and treatment options for both mental health conditions.
Obsessive-compulsive disorder is a debilitating mental health condition which has two main components: obsessions and compulsions. 
Obsessions are unsolicited, intrusive thoughts, images, and urges that constantly plague people with OCD. An affected person might know that their obsessions are not rational, but they cannot control them from reoccurring. 
Compulsions are repeated behaviors that sufferers of OCD use to address their obsessions. They can be thought of as rituals adopted to alleviate the anxiety brought on by obsessions.  However, any relief is only temporary and in the long term, performing a compulsion heightens anxiety and does not cure an obsession.
The Diagnostic and Statistical Manual of Mental Disorders’ fifth edition (DSM-5) criteria for an OCD diagnosis is as follows: 
OCPD is a personality disorder characterized by a fixation on rules, orderliness, cleanliness, and organization at all costs.  People with OCPD will seek to maintain control over every detail of a situation, paying excessive attention to every rule and detail no matter how trivial. 
They are unaware of how often others are annoyed with their hairsplitting approach to life, the delays that accompany even the smallest of tasks, and their sense of moral superiority. 
OCPD is one of the most widely diagnosed personality disorders across the USA, with prevalence estimated to be between 2% and 8%.
According to the DSM-5, OCPD is diagnosed when there exists a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood. This is deemed to exist when four or more of the following symptoms are presented: 
Despite being distinct mental health conditions with separate diagnostic criteria, there is some overlap between OCD and OCPD:
While the above similarities can be noted, there are core differences between the symptoms of OCD and OCPD.
Obsessions and Compulsions
OCD is marked by the presence of obsessions, which are distressing thoughts or urges, and compulsions, which are irrational, repeated behaviors intended to soothe the obsessions. Patients can get into cycles of obsessions and compulsions, leaving them consumed by tackling these anxiety-inducing behaviors. 
On the other hand, OCPD is not characterized by repeated rituals performed to soothe obsessive thoughts. Instead of obsessions and compulsions, people with OCPD demonstrate a need for orderliness, perfectionism, and control at the cost of anything else. 
People with OCD often recognize their behavior is irrational, misaligned with reality, and potentially disrupting others around them. Whilst this doesn’t make the disorder any easier to contend with, they retain a sense of self-awareness. 
People with OCPD, however, typically have a lack of insight into how their behavior is perceived by others and often do not consider it to be problematic.  They believe their behavior is correct and justified, are far less self-aware, and are thus more susceptible to hurting other peoples’ feelings. Conflict is common for people with OCPD, with family members, for example, often feeling heavily criticized and controlled. 
Impact on daily life
OCD typically impacts several different areas of a person’s life, including their ability to focus at work, desire to socialize, and ability to carry out daily tasks. 
OCPD usually impairs people’s interpersonal relationships, which can have negative consequences for all areas of life. However, it doesn’t necessarily detract from a person’s ability to work or complete tasks. In many cases, it can make people more efficient. Commonly, it’s not the job that’s hurt by a person’s OCPD, it’s the relationships with co-workers or other people involved in an organization. 
The causes of both OCD and OCPD are not explicitly known, but there are several factors that are thought to contribute to a person’s risk of contracting either disorder.
Genetic Factors - There is evidence that OCD can run in families, suggesting a genetic component. Having a close family member with OCD increases the risk of developing the disorder. 
Neurological functioning - Certain brain areas and neurotransmitters are impacted in the development of OCD. The brain circuits involving the frontal cortex, basal ganglia, and limbic system (particularly the amygdala) are believed to be involved in the development of OCD, but that connection is unclear.  Serotonin deficiencies in the brain have also been linked with OCD.
Environmental factors – Certain environmental factors, such as childhood trauma, abuse, or neglect, have been reported to play a part in the development of OCD.  Brain injury, infection, pregnancy complications, and the occurrence of stressful events are all factors that have been shown to contribute to a person’s OCD. 
Negative early life experiences - Adverse childhood experiences, such as neglect, abuse, or inconsistent parenting, may contribute to the development of OCPD. Traumatic events or a highly controlled or over-protective upbringing may increase the risk of developing perfectionistic and controlling tendencies associated with OCPD. 
Genetic factors – Some studies suggest that there is a genetic component to the development of OCPD, however this hasn’t been well studied.
Environmental factors - Cultural or societal influences that emphasize strict rules, order, and perfectionism may contribute to the formation of OCPD traits.  Children bound by strict rules may struggle with personality development and expression. 
The treatment options for OCD and OCPD are similar, with medication, talk therapy, or a combination of both being frontline options.
Below we’ll discuss the ways each disorder can be treated:
Medication – Selective serotonin reuptake inhibitors (SSRIs) are the type of medication used to treat OCD.  Examples include fluoxetine, fluvoxamine, or sertraline, can help reduce the frequency and intensity of obsessions and compulsions.
Psychotherapy – Cognitive behavior therapy (CBT) is the primary therapy used to treat OCD, with patients encouraged to recognize negative thought patterns and learn coping strategies to avoid performing compulsions.
A particularly effective from of CBT is exposure and response prevention (ERP), which involves gradual and systematic exposure to the feared obsessions while preventing the associated compulsive behaviors. Over time, patients learn to tolerate their obsessions without performing compulsions. 
Self-care - Establishing a structured routine, maintaining a balanced lifestyle, and prioritizing self-care can contribute to overall well-being and symptom management.
Medication – Similarly to OCD, people with OCPD may be prescribed SSRIs to lessen how rigid they are and relax their fixation on orderliness. 
Psychotherapy – Talk therapy focused on improving a person’s insight such as psychodynamic therapy, can be helpful for some people with OCPD.  It can help a person explore the underlying reasons behind their pursuit of perfection, control issues, and rigidity.
Relaxation techniques – Individuals with OCPD can benefit from relaxation exercises to manage stress and reduce the sense of urgency that accompanies OCPD .
It must be noted that patient’s attitudes towards treatment can vary. People with OCD often see the need for treatment, while those with OCPD aren’t often aware there is any fault in their behavior. As such, it can be more challenging to initiate treatment in people with OCPD than OCD.
Yes, it is possible for both conditions to exist comorbidly, with research suggesting that OCPD occurs in individuals with OCD 15% to 28% of the time.