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Personality disorders in obsessive compulsive disorder.

L Baer1, M A Jenike

  • 1Department of Psychiatry, Harvard Medical School, Massachusetts.

The Psychiatric Clinics of North America
|December 1, 1992
PubMed
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Most patients with obsessive-compulsive disorder (OCD) have comorbid personality disorders, often developing over time. Schizotypal personality disorder is a key predictor of poorer OCD treatment outcomes.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Standardized personality scales offer improved reliability over clinical interviews for diagnosing personality disorders.
  • Diagnostic criteria for personality disorders have evolved, with the DSM-III-R focusing more on illness than Freudian concepts.

Purpose of the Study:

  • To investigate the prevalence and impact of Axis II personality disorders in patients with obsessive-compulsive disorder (OCD).
  • To explore the relationship between OCD duration, personality disorder development, and treatment outcomes.

Main Methods:

  • Utilized standardized structured interview personality scales to assess Axis II personality disorders in 96 adult OCD patients.
  • Analyzed the temporal relationship between OCD onset and personality disorder diagnosis.

Related Experiment Videos

  • Examined personality disorder changes following successful OCD treatment.

    • Main Results:

    • The majority of OCD patients exhibit at least one Axis II personality disorder, predominantly from Cluster C.
    • Obsessive-compulsive personality disorder is less common in OCD patients than other disorders like mixed, dependent, avoidant, and histrionic.
    • Mixed personality disorder prevalence increased with OCD duration, suggesting secondary development.
    • Successful OCD treatment led to some patients no longer meeting criteria for certain personality disorders.
    • Schizotypal personality disorder emerged as the sole consistent predictor of poorer OCD treatment outcomes.

    Conclusions:

    • Comorbid personality disorders are highly prevalent in OCD, with some potentially developing secondary to the disorder.
    • Personality traits may develop as adaptive mechanisms in response to OCD.
    • Schizotypal personality disorder is a significant indicator of a less favorable prognosis for OCD treatment.