Obsessive–compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions being unwanted, recurring and stressing thoughts, ideas or images, compulsions being repetitive behaviours carried out by patients in order to decrease anxiety and or tension caused by obsessions. The overlap between OCPD and the Axis I OCD has long been a source of much debate (Albert, Maina, Forner, & Bogetto, 2004; Emmelkamp, 1982; Rodriques, Torres, & Del Porto, 1995; Serpell, Livingstone, Neiderman, & Lask, 2002). Freud held that anally fixated persons (i.e., obsessive–compulsive personality) have a predisposition to the development of OCD. Some hold that obsessive personality traits are a necessary prerequisite for the development of OCD symptoms. Others however claim that there is no (clear) link between OC personality traits and OCD symptoms. Overarching these extremes is the idea that while symptoms and personality traits can be jointly present quite regularly, this may be attributed to chance rather than to a direct relationship (Emmelkamp, 1982; Rosen & Tallis, 1995). Troughout the years, studies report rates of co-morbidity with either PD traits or full PD diagnoses, varying from 2–55% (Black & Noyes, 1997; Black, Noyes, Pfohl, Goldstein, & Blum, 1993). Different methods of Axis II assessment (e.g. structured interviews vs. self-report questionnaires) may to some extent account for the differences found. Some report a specific association of OCPD with OCD compared to panic disorder and major depressive disorder (Diafera et al., 1997). Others however, found hardly any evidence that OCD and OCPD are specifically associated (e.g. Crino & Andrews, 1996; Pfohl & Blum, 1991; Pollak, 1979, 1987). More recently, Mancebo, Eisen, Grant, and Rasmussen (2005) reviewed research in this area and concluded that the majority of individuals with OCD in clinical samples (75%) do not have OCPD. In addition, results from PD samples suggest that the majority of individuals with OCPD (80%) do not fulfil the criteria of OCD. Reporting on data from the British National Survey of Psychiatric Morbidity 2000, Torres et al. (2006) could show only a trend for OCPD to be more frequent in OCD individuals. The assessment of PDs, however, was based on the screening questionnaire of the Structured Clinical Interview for Axis II disorders, rather than on a structured interview. Please note that screening instruments are known for their overrating tendency. Other recent studies found the percentage of OCD patients with OCPD to be relatively low ranging from 15% (Wu, Clark, & Watson, 2006) to 25% (Pinto, Mancebo, Eisen, Pagano, & Rasmussen, 2006) Of note, Wu et al. (2006) reported that OCD patients scored higher than non-patients on both avoidant and dependent PD. Only one study (Eisen et al., 2006) found that OCD was significantly more prevalent in subjects with OCPD (as assessed by DIPD-IV interview) compared to subjects with other PDs. Three of the OCPD criteria (hoarding, perfectionism and preoccupation with details) were significantly more prevalent in OCD subjects.
There is some evidence, however, that a specific subgroup of OCD patients has an elevated chance of co-occurring OCPD. Coles, Pinto, Mancebo, Rasmussen, and Eisen (2008) reported that the presence of OCPD (assessed by SCID-II) in OCD individuals is significantly associated with a number of specific clinical features including an earlier age at onset of initial OCD symptoms, greater frequency of symmetry and hoarding obsessions and greater frequency of cleaning, ordering, repeating and hoarding compulsions. Moreover, the group of OCD individuals with OCPD was characterized by more impaired social functioning and lower Global Assessment of Functioning ratings, which suggest that there may be a specific subtype of OCD characterized by the presence of OCPD.
Finally, a study of Calvo et al. (2009) is of some interest. They found OCPD traits to be significantly more prevalent in parents of children with OCD compared to parents of healthy controls. Specifically, hoarding, perfectionism and preoccupation with details were significantly more present in probands' parents.