Which diagnosis best fits duration, episodicity, and exclusions?
A
Obsessive-compulsive personality disorder (OCPD)
Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
Presence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both
APervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
BPresence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both
Additional criteria
ANo additional structured criteria supplied
BB. Obsessions/compulsions are time-consuming (>1 hr/day) or cause clinically significant distress/impairment C. Not attributable to physiological effects of a substance or another medical condition D. Not better explained by symptoms of another mental disorder
Key features
AA. Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
BA. Presence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both B. Obsessions/compulsions are time-consuming (>1 hr/day) or cause clinically significant distress/impairment C. Not attributable to physiological effects of a substance or another medical condition
Common specifiers
AMild / Moderate / Severe
BWith good or fair insight; With poor insight; With absent insight / delusional beliefs; Tic-related
Differential flags
AOCD (ego-dystonic intrusive obsessions + compulsions; not a personality style); Narcissistic PD (perfectionism driven by need for admiration); ASD (rigidity is neurodevelopmental; different onset and profile)
BGAD (worry is ego-syntonic, future-focused, realistic - OCD obsessions are ego-dystonic, intrusive, irrational); OCPD (ego-syntonic perfectionism without obsessions/compulsions); MDD (rumination is mood-congruent, not intrusive; no compulsions)