(PS7-79) Stability of Individual Obsessive-compulsive Personality Disorder Symptom Criteria over Six Years of Prospective Follow-up

Background

Obsessive-compulsive personality disorder (OCPD) is defined as having at least four of the following eight criteria: a) miserly spending style; b) excessive work devotion; c) perfectionism; d) reluctance to delegate; e) detail-oriented; f) inflexible, overconscientious, scrupulous; g) rigidity and stubbornness; h) hoarding; and i) indecision. Although personality disorders are presumed to be stable, some research suggests that personality disorders contain both enduring and episodic features (Sanislow et al., 2009; Shea et al., 2002). Indeed, prior limited research investigating the stability of OCPD symptom criteria shows mixed results, with some criteria exhibiting greater stability than others over two-year follow-up (Grilo et al., 2004; McGlashan et al., 2005). Thus, our study aims to investigate the stability of OCPD symptoms over six years.

Methods

Participants were 32 individuals with a diagnosis of OCPD. They were a subset adult sample of individuals who were part of the Brown Longitudinal Obsessive-Compulsive Study and all had a primary diagnosis of OCD (Pinto et al., 2006). The Structured Clinical Interview for DSM-IV Axis I Disorders - Patient Version was used to diagnose OCD at baseline. The SCID-II was used to diagnose OCPD at baseline, year 3, and year 6. Cochran’s Q tests were conducted to assess whether there were significant changes in the proportion of individuals who endorsed each of the eight OCPD symptom criteria across the three time points. Follow-up paired McNemar’s tests were conducted for the criteria that showed significant changes.

Results

The following OCPD symptom criteria were stable over time: being detail-oriented (Cochran’s Q (2)=3.17, p=.21), reluctance to delegate (Cochran’s Q (2)=4.20, p=.12), being inflexible, overconscientious, scrupulous (Cochran’s Q (2)=0.13, p=.94), excessive work devotion (Cochran’s Q (2)=4.13, p=.13), and miserly spending style (Cochran’s Q (2)=0.22, p=.90). By contrast, perfectionism (Cochran’s Q (2)=7.82, p< .05), rigidity and stubbornness (Cochran’s Q (2)=10.86, p< .01), and hoarding (Cochran’s Q (2)=7.00, p< .05) were unstable.

Conclusion

Results indicate that OCPD includes both stable and unstable criteria. This suggests the need for a potential refinement of OCPD diagnostic criteria, as the current system gives equal weight to both persistent and intermittent criteria. Future research should try to replicate our findings using a more diverse sample over a longer span of time using more time points.