Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Obsessive-compulsive personality disorder (OCPD) is an early-onset condition marked by perfectionism, control needs, and cognitive rigidity.
• Its diagnostic classification is under review, with historical links to obsessive-compulsive disorder (OCD).
• The establishment of the obsessive-compulsive and related disorders (OCRD) category in DSM-5 necessitates re-evaluation of OCPD's nosological status.

Purpose of the Study:

• To discuss the diagnosis of OCPD in anticipation of its ICD-11 review.
• To analyze OCPD's relationship with OCD, DSM-5 OCRDs, other compulsive disorders (eating disorders, autistic spectrum disorder), and personality disorders.
• To provide recommendations for OCPD's optimal placement in diagnostic systems and identify key research questions.

Main Methods:

• Review of existing literature on OCPD and related disorders.
• Analysis of nosological determinants including phenomenology, illness course, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response.
• Comparative analysis with DSM-5 OCRD and other relevant conditions.

Main Results:

• OCPD shares characteristics with OCD and related disorders, but also with personality disorders.
• Understanding these relationships is crucial for accurate diagnosis and treatment.
• The study highlights the need for further research to clarify OCPD's distinct features and classification.

Conclusions:

• OCPD's optimal placement in diagnostic systems requires careful consideration of its unique and shared features.
• Further research is needed to address key questions regarding its etiology, course, and treatment.
• Clarifying OCPD's diagnostic status will improve clinical utility and research planning.