OCPD tends to occur in families, so genes may be involved. A person's childhood and environment may also play roles.

This disorder can affect both men and women. It occurs more often in men.

OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). People with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct. In addition, OCD often begins in childhood while OCPD usually starts in the teen years or early 20s.

People with either OCPD or OCD are often high achievers and feel a sense of urgency about their actions. They may become very upset if other people interfere with their rigid routines. They may not be able to express their anger directly. People with OCPD have feelings that they consider more appropriate, like anxiety or frustration.

A person with OCPD has symptoms of perfectionism that usually begin by early adulthood. This perfectionism may interfere with the person's ability to complete tasks because their standards are so rigid. They may withdraw emotionally when they are not able to control a situation. This can interfere with their ability to solve problems and form close relationships.

Other signs of OCPD include:

• Over-devotion to work
• Not being able to throw things away, even when the objects have no value
• Lack of flexibility
• Lack of generosity
• Not wanting to allow other people to do things
• Not being willing to show affection
• Preoccupation with details, rules, and lists

OCPD is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms have been.

Medicines may help reduce anxiety and depression from OCPD. Talk therapy is thought to be the most effective treatment for OCPD. In some cases, medicines combined with talk therapy is more effective than either treatment alone.

The outlook for OCPD tends to be better than that for other personality disorders. The rigidness and control of OCPD may prevent many of the complications, such as substance use disorder, which are common in other personality disorders.

The social isolation and difficulty handling anger that are common with OCPD may lead to depression and anxiety later in life.

Complications may include:

• Anxiety
• Depression
• Difficulty moving forward in career situations
• Relationship difficulties

See your provider or mental health professional if you or someone you know has symptoms of OCPD.

Personality disorder - obsessive-compulsive; OCPD

American Psychiatric Association. Obsessive-compulsive and related disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Blais MA, Rivas-Vazquez R, Ruchensky JR, Stein MB. Personality and personality disorders. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 37.

Pinto A, Teller J, Wheaton MG. Obsessive-compulsive personality disorder: A review of symptomatology, impact on functioning, and treatment. Focus (Am Psychiatr Publ). 2022;20(4):389-396. PMID: 37200888 pubmed.ncbi.nlm.nih.gov/37200888/.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.