Seven-Year Stability of Obsessive-Compulsive Personality Disorder Symptom Criteria in Individuals with Obsessive Compulsive Disorder

Background: Obsessive-compulsive disorder (OCD) commonly co-occurs with personality disorders, particularly obsessive-compulsive personality disorder (OCPD). Recent research suggests that personality disorders, especially OCPD, might not be as stable as once thought. The current study investigates the longitudinal stability of OCPD diagnosis and individual symptom criteria in individuals with OCD. Methods: 320 participants with a primary diagnosis of OCD were included in the study, with diagnostic assessments conducted annually for seven years. Logistic mixed-effects models were conducted to examine the relationship between time and OCPD diagnosis, as well as the relationship between time and each OCPD symptom criterion over seven years. Results: In individuals with OCD, time was a significant predictor of OCPD diagnosis which indicated diagnostic instability, with the likelihood of OCPD diagnosis decreasing over time. Three individual criteria (detail-oriented, inflexible, overconscientious, and scrupulous, and miserly spending style) were shown to be stable while the other five (perfectionism, reluctance to delegate, rigidity and stubbornness, excessive work devotion, and inability to discard) were unstable. Conclusion: OCPD diagnosis is not stable in individuals with OCD and consists of a mix of enduring and episodic symptom criteria. It suggests the need for a refinement of OCPD diagnostic criteria and future research on symptom stability of OCPD across different diagnostic groups.