History and Epidemiology of OCPD; Chapter 1

Abstract

Obsessive-compulsive personality disorder (OCPD) is characterized by a pervasive and maladaptive pattern of excessive perfectionism, preoccupation with orderliness and details, and need for control over one's environment (Wheaton and Pinto 2017). The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines personality disorders as impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits and categorizes personality disorders into three different clusters (A, B, and C) based on descriptive similarities. OCPD is classified as one of three Cluster C ("anxious-fearful") personality disorder types. DSM-5 specifically emphasizes that OCPD traits of orderliness, perfectionism, and mental and interpersonal control are expressed at the expense of flexibility, openness, and efficiency (American Psychiatric Association 2013). Developers of the International Classification of Diseases, 11th Revision (ICD-11), are moving toward a dimensional model of personality disorder assessment, which involves an evaluation of both personality disorder assessment, which involves an evaluation of both personality disorder severity - mild, moderate, or severe - and the presence of five stylistic trait domains - negative affectivity, detachment, disinhibition, dissociality, and anankastia (World Health Organization 2018). Notably, the DSM-5 defination of OCPD considerably overlaps with the ICD-11 proposed trait of anankastia, which is described as rigid perfectionism as well as controlling behavior and situations to ensure confirnity to standards (World Health Organization 2018). Despite the recent developments in diagnostic classification, OCPD remains a relatively underexplored area of psychiatry, and its nosological status remains controversial (Fineberg et al. 2015). [...].