Obsessive-Compulsive Personality Disorder

By | June 10, 2022

There is talk of an obsessive-compulsive personality disorder when the affected person shows rigid and perfectionistic thinking and acting. They suffer from strong doubts and indecisiveness.

What is Obsessive-Compulsive Personality Disorder?

In medicine, obsessive- compulsive personality disorder is also known as obsessive -compulsive personality disorder or anankastic personality disorder. The term comes from the ancient Greek word ananke and means “compulsion” or “inevitability”. Typical features of the compulsive personality disorder are perfectionism, compulsion to control, mental immobility, anxious caution and strong doubts.¬†For increased intracranial pressure definition and meaning, please visit howsmb.com.

However, obsessive-compulsive personality disorder differs significantly from the usual obsessive-compulsive disorder. Thus, obsessive-compulsive disorder represents an axis I disorder in which primarily an ego-dystonic symptom occurs. The reason for this are disorders of the brain metabolism. Obsessive-compulsive personality disorder, on the other hand, is an Axis II mental disorder. This is predominantly characterized by ego-syntonous complaints.

Overall, around two to five percent of the population suffer from an obsessive-compulsive personality disorder. It occurs twice as often in males as in females. Anankastic personality disorder is often associated with depression. In addition, other obsessive-compulsive disorders may be present at the same time.


The exact causes of obsessive-compulsive personality disorder are not yet well known. They are not caused by other psychiatric disorders or direct brain damage. From a psychoanalytic point of view, strict and punitive toilet training is suspected. As a result, the affected persons developed a strongly developed so-called “super-ego”.

The patients place extremely high demands on order and cleanliness. At the same time, there is a strong inhibition in them. Many psychoanalysts suspect that during the patients’ childhood there was considerable power struggles with the parents for control. These led to aggressive impulses, which were suppressed by those affected.

Patients gain control over their behavior by stubbornly sticking to their habits and rules. However, there was hardly any scientific evidence for this theory. Cognitive therapy assumes that specific thought processes are important in maintaining OCD.

For example, patients often exhibit pronounced black-and-white thinking. They also have an exaggerated fear of negative repercussions if they make mistakes themselves. This in turn results in a perfectionist, rigid, inflexible and at the same time very hesitant behavior.

Symptoms, Ailments & Signs

Typical symptoms of an obsessive-compulsive personality disorder are the conspicuous behavior of the patients. So they basically have a lot of doubts about themselves, but also about other people. A characteristic feature of anankastic personality disorder is that sufferers take on a variety of tasks that need to be performed to perfection.

However, they often lose track of what is happening. Furthermore, the patients feel a permanent feeling of control. It doesn’t matter whether the tasks they do are important or not. Those affected do not set specific priorities. While unimportant tasks are given priority, important things are neglected and postponed.

People who suffer from OCD often act rationally and logically. However, they do not tolerate other people’s feelings. Also, they fail to show warmth towards those around them. Work and productivity take precedence over pleasure and socializing.

Recreational activities are planned in detail and are not changed. Another characteristic of obsessive-compulsive personality disorder is stubbornness and selfishness. Other people are asked to submit to the patients.

Diagnosis & course of disease

Clinical-psychological examinations are required to diagnose an obsessive-compulsive personality disorder. The therapist deals with the patient’s anamnesis, creates a psychopathological diagnosis and carries out psychological tests. The presence of at least four typical characteristics or behaviors is decisive for the diagnosis.

These include the patient’s constant preoccupation with order, rules, planning, and detail, excessive doubt and caution, perfectionism that hinders the completion of tasks, and overconscientiousness that neglects interpersonal relationships and pleasure.

Other possible criteria are stubbornness, rigidity, exaggerated pedantry and the intrusion of unwanted thoughts. A cure for the obsessive-compulsive personality disorder is not yet possible. Neither pharmacological nor psychotherapeutic treatment approaches have been sufficiently investigated.


Many personality disorders coexist with one or more forms. This also applies to the obsessive-compulsive personality disorder. Anxious-avoidant personality disorder is the most common along with obsessive-compulsive personality disorder. Three percent of those affected suffer from this additional personality disorder.

The anxious-avoidant personality disorder can develop as a direct consequence of the obsessive-compulsive personality disorder, since those affected often fear that their own (very high) standards will not be met. Obsessive-compulsive disorder can also occur as a complication of obsessive-compulsive personality disorder. These are characterized by obsessive thoughts or compulsions, where the sufferer usually knows that the compulsion itself is pointless or excessive.

Another possible complication of obsessive-compulsive personality disorder is mood disorders. Depression in particular is common. The spectrum ranges from mild depressive moods to chronic depressive moods (dysthymia) and major depression. Suicidality is a possible complication of depression or depressed mood.

The compulsive personality disorder can also occur together with an eating disorder. Exaggerated perfectionism is particularly typical for anorexics, which can also be found in the compulsive personality disorder. However, other eating disorders are also possible. An eating disorder can cause other complications, including severe physical consequences of the disease. Examples include electrolyte imbalances, neurological disorders, and osteoporosis.

When should you go to the doctor?

People exhibiting behavior that can be described as abnormal should be evaluated by a doctor. If there are intentional injuries of an emotional or physical nature to other people or recurring disturbances in social behavior, it is advisable to consult a doctor. Compulsive acts, high levels of self-doubt, and violating social norms are causes for concern. If the execution of assigned obligations is done to a constantly perfectionist extent, this should be interpreted as a red flag.

People from the immediate social environment should point out the abnormalities to those affected. If the urge for perfectionism is continuously intensified, the person concerned needs help. Addiction to control, loss of realism, and taking on countless tasks are other signs of a health disorder. A gradual increase in behavioral problems is characteristic.

In some cases, the peculiarities appear after a fall, accident or trauma to the head. There is a need for action in the event of sudden or continuous abnormalities in occurrence. If there is a lack of tolerance, empathy and consideration for other people, the procedure should be considered more closely. The manifestation of the obsessive-compulsive personality disorder includes the affected person’s lack of insight. Therefore, the cooperation of a relative is often necessary. Only if there is a good relationship of trust with another person does the person concerned consult a doctor on their advice.

Treatment & Therapy

Since there is no cure for anankastic personality disorder, the focus of therapy is on improving the patient’s social skills. The focus is also on structuring your environment and applying what you have learned in everyday life. The most important therapy concepts are sociotherapy and psychotherapy.

In most cases, however, the patients do not go to a therapist on their own initiative, but because they are under strong social pressure from their partner or family. Of particular importance for the success of the treatment is a stable relationship between therapist and patient, which should be strengthened right at the beginning of therapy. However, building this relationship can be challenging.

Failure to establish a good relationship will usually result in the end of therapy. If there is a comorbidity such as depression, medication such as antidepressants can be administered. In the case of accompanying anxiety disorders, the patient is often given neuroleptics. Other helpful drugs are lithium and carbamazepine.


Unfortunately, it is not possible to prevent obsessive-compulsive personality disorder. The triggering causes of the mental disorder have not yet been fully researched.

You can do that yourself

If the person concerned has recognized that he / she suffers from an obsessive-compulsive personality disorder, the first step towards improvement has already been taken. However, there is still a long way to go for those affected to get better. Psychotherapy and sociotherapy are the measures that should most often accompany this path.

Insight is the first step. But it is important that those affected become aware of their illness every day in order to be able to recognize and break through patterns. Sick people often withdraw from their social environment, if they are involved in one at all. But this retreat is very destructive. If those affected know this about themselves, they have the opportunity to act against it and consciously seek contact with loving fellow human beings. It is the same with perfectionism and the need for control, from which most sufferers suffer. If the sick person is aware of this, he / she can only take the necessary steps against it. Recognizing that this behavior is detrimental to one’s health is a significant step. It is important to be aware of your own needs in everyday life,

Self-help can only play a supporting role in therapy.

Obsessive-Compulsive Personality Disorder