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

Abstract

Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessivecompulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD) category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category), as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials.

Structure of DSM‐5 and ICD‐11 personality domains in Iranian community sample

“…Yet literature suggests that anankastic (obsessive-compulsive) PD may include individuals who are predominantly characterized by stubbornness and irritability, while others are primarily characterized by uncertainty and anxiousness. 47 Accordingly, the present study may indicate that anankastic features in Iran are characterized by Hostility, whereas anankastic features in Denmark are characterized by Anxiousness and Distractibility. 14 This is also consistent with Millon's 48 subtypes of obsessive-compulsive PD including the Conscientious subtype (marked self-doubts, indecisive, dreads error and mistakes), the Bureaucratic subtype (high-handed and intrusive) and the Puritanic subtype (uncompromising and judgmental), where Anankastic features in Iran seem most characterized by the latter two types.…”

“…Notably, in the present study, Hostility was primarily loading on Anankastia (instead of Dissociality or Negative Affectivity). Yet literature suggests that anankastic (obsessive–compulsive) PD may include individuals who are predominantly characterized by stubbornness and irritability, while others are primarily characterized by uncertainty and anxiousness . Accordingly, the present study may indicate that anankastic features in Iran are characterized by Hostility, whereas anankastic features in Denmark are characterized by Anxiousness and Distractibility .…”

The Unbearable Lightness of the Academic Work: The Positive and Negative Sides of Heavy Work Investment in a Sample of Italian University Professors and Researchers

“…Some researchers define workaholism as a pathology, however, it is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Similarly, studies have considered workaholism as a symptom of obsessive-compulsive personality disorder, which is typically characterized by perfectionism and excessive devotion to work [51,52].…”

Robot models of mental disorders

“…The main difference between OCD and OCPD is that OCPD is part of the person's personality and therefore perceived by them as normal, rather than unwanted. However, whether OCPD should be considered within the OC spectrum is an open question [4].…”