Which feature best distinguishes obsessive-compulsive personality disorder from obsessive-compulsive disorder?
- A Presence of magical thinking in OCPD
- B OCD responds to psychotherapy whereas OCPD responds only to medication
- C The behaviours of OCPD are ego-syntonic, whereas obsessions and compulsions of OCD are ego-dystonic ✓
- D OCPD begins in childhood whereas OCD always begins after the age of 30
Correct answer: C. The behaviours of OCPD are ego-syntonic, whereas obsessions and compulsions of OCD are ego-dystonic
Explanation
In OCPD the rigidity and perfectionism are experienced as natural and desirable by the patient, that is ego-syntonic, and there are no true recurrent intrusive obsessions or ritualised compulsions performed to neutralise anxiety. In OCD the intrusions are unwanted and resisted, that is ego-dystonic. Magical thinking belongs to schizotypal personality disorder, and neither condition is restricted to any particular age of onset.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.
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