OCD and OCPD have similar names, but they’re completely different conditions. Here’s why the difference matters.
Obsessive-compulsive disorder (OCD) has different symptoms, treatments, and causes than obsessive-compulsive personality disorder (OCPD). One is a personality disorder, meaning it’s defined by stable, long-term personality traits. The other is defined by obsessive thoughts and compulsive actions.
That said, it’s possible to have both conditions at the same time.
Both conditions are treatable with psychotherapy (talk therapy). If you think you or a loved one has one, or both, of these conditions, it may help to talk with a mental health professional.
The major differences between OCD and OCPD are apparent in their definitions:
- OCD is a mental health condition where you experience unwanted, persistent thoughts (obsessions) and the urge to carry out repetitive behaviors (compulsions).
- OCPD is a personality disorder characterized by extreme perfectionism, a need to control, rigid thinking, and adherence to rules.
Below, we take a closer look at the differences between these two conditions.
1. How they are classified
Both mental health conditions appear in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). While OCPD is listed as a personality disorder, OCD is classified under “obsessive-compulsive and related disorders.”
OCPD is characterized by long-standing patterns of behavior. Traits related to OCPD, like perfectionism, arise across all aspects of life, including work, home life, and hobbies.
On the other hand, the symptoms of OCD center around patterns of emotions — especially anxiety and fear. OCD symptoms arise in response to specific triggers or situations.
2. Different symptoms
The DSM-5 provides separate lists of symptoms that define each condition:
The symptoms of OCD fall into two interlinked categories: obsessions and compulsions.
- Obsessions are recurrent, persistent, distressing images and thoughts.
- Compulsions are repetitive behaviors that the person feels urged to do to make the obsessions go away. Compulsions can include pacing, ordering objects, or handwashing, or mental acts, like repeating mantras or praying.
Both obsessions and compulsions are upsetting to the person who has OCD. They won’t enjoy engaging with their obsessions or carrying out their compulsions; to them, it’s a source of distress.
Obsessive-compulsive personality disorder
OCPD involves neither obsessions nor compulsions. Instead, the condition involves being excessively preoccupied with perfectionism, order, and control over your environment. Rigid thinking patterns, such as all-or-nothing thinking, are common in people with OCPD.
According to the DSM-5, a person needs to display four or more of the following traits across situations for a diagnosis of OCPD:
- preoccupation with rules, details, organization, schedules, and tracking processes
- feeling an urgency to reach perfection, which gets in the way of completing tasks
- prioritizing work and productivity over interpersonal relationships and relaxation
- being extremely conscientious, inflexible, and scrupulous when it comes to your own beliefs, values, and ethics, often struggling to accept the beliefs of others
- not being able to discard unused, broken, worn-out, or useless objects
- having extreme difficulty delegating tasks or negotiating with others, unless they’re willing to adhere to your ways
- going to extremes to save money and limit expenses for yourself and others, even when unnecessary
- adhering to rigid thinking patterns and stubbornness
However, not everyone with OCPD will have all of the symptoms, and not everybody who displays some of those characteristics has OCPD.
3. Distress about symptoms
While people with OCD feel distressed about their symptoms, someone with OCPD will likely take pride in their perfectionism and conscientiousness. This often makes it harder for someone with OCPD to recognize when they need mental health support.
4. Difficulties with daily life
OCD can take up a great deal of time and energy. People with OCD often spend a lot of time carrying out compulsions. This can make it difficult to execute daily tasks, including work or school activities, social events, chores, and hobbies.
People with OCPD are typically diligent workers who seem to function well. However, they might have difficulties maintaining relationships because of their inflexibility and difficulties with giving up control. They might also find it hard to complete tasks due to perfectionism.
5. Motivating factors
Those with OCD are usually motivated by fear, anxiety, or discomfort.
On the other hand, people with OCPD tend to be preoccupied with perfection simply because they feel it is right.
Yes, it’s possible to have both conditions. In fact, approximately 15% to 28% of people with OCD also have OCPD.
Both OCD and OCPD are treated through psychotherapy. You don’t need to have a diagnosis in order to benefit from therapy. Cognitive behavioral therapy (CBT) is a common treatment for OCD and OCPD.
In addition to CBT, mental health professionals may treat OCD with:
- exposure response and prevention (ERP) therapy, a type of CBT
- acceptance and commitment therapy (ACT)
- Eye Movement Desensitization and Reprocessing (EMDR) therapy
In addition to CBT, mental health professionals may treat OCPD with:
With that said, the type of therapy that works for you depends on a range of factors. Many therapists draw from different types of therapy to meet your needs.
OCD treatment might also involve certain prescription medications, particularly antidepressants like selective serotonin reuptake inhibitors (SSRIs). OCPD isn’t typically treated with medication, but a mental health professional might prescribe medication if necessary.
OCD and OCPD sound similar, but they’re two very different mental health conditions. However, both disorders can be treated and managed effectively.
If you think you might have OCD, OCPD, or both, speaking with a therapist can help you take the first step in managing your symptoms.
Looking for a therapist, but not sure where to start? Psych Central’s How to Find Mental Health Support resource can help.
The following information resources and support groups might be helpful: