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Obsessive compulsive Personality Disorder and Autism Spectrum Disorder Traits in the Obsessive-compulsive Disorder Clinic

Published online by Cambridge University Press:  23 March 2020

W. Gadelkarim ,
S. Shahper ,
J. Reid ,
M. Wikramanayake ,
S. Kaur ,
S. Kolli ,
N. Fineberg  and
S. Osman
W. Gadelkarim
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust & North Essex Partnership University NHS Foundation Trust, Highly Specialized OCD services, Welwyn Garden City, United Kingdom
S. Shahper
Affiliation:
University of Hertfordshire, Highly Specialized OCD service, Welwyn Garden City, United Kingdom
J. Reid
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust, Highly Specialized OCD services, Welwyn Garden City, United Kingdom
M. Wikramanayake
Affiliation:
Cambridge and Peterborough foundation trust, Acute Mental Health services, Cambridge, United Kingdom
S. Kaur
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust, Crisis Assessment & Treatment Team, Welwyn Garden City, United Kingdom
S. Kolli
Affiliation:
East London Foundation Trust, Early Intervention Team, Bedford, United Kingdom
N. Fineberg
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust & University of Hertfodshire, Highly Specialized OCD services, Welwyn Garden City, United Kingdom
S. Osman
Affiliation:
Northumbria Tyne and Wear NHS Foundation Trust, General Adult, Northumberland, United Kingdom

Abstract

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Introduction

Obsessive Compulsive Personality Disorder (OCPD) is a common, highly co-morbid disorder. Subjected to comparatively little research, OCPD shares aspects of phenomenology and neuropsychology with obsessive-compulsive spectrum disorders and neurodevelopmental disorders such as autism spectrum disorder (ASD). A greater understanding of this interrelationship would provide new insights into its diagnostic classification and generate new research and treatment heuristics.

Aims

To investigate the distribution of OCPD traits within a cohort of OCD patients. To evaluate the clinical overlap between traits of OCPD, OCD and ASD, as well as level of insight and treatment resistance.

Method

We interviewed 73 consenting patients from a treatment seeking OCD Specialist Service. We evaluated the severity of OCPD traits (Compulsive Personality Assessment Scale; CPAS), OCD symptoms (Yale–Brown Obsessive Compulsive Scale; Y-BOCS), ASD traits (Adult Autism Spectrum Quotient; AQ) and insight (Brown Assessment of Beliefs Scale; BABS).

Results

Out of 67 patients, 24 (36%) met DSM-IV criteria for OCPD, defined using the CPAS. Using Pearson's test, CPAS scores significantly (P < 0.01) correlated with total AQ and selected AQ domains but not with BABS. Borderline significant correlation was observed with Y-BOCS (P = 0.07). OCPD was not over-represented in a highly resistant OCD subgroup.

Conclusion

Disabling OCPD traits are common in the OCD clinic. They strongly associate with ASD traits, less strongly with OCD severity and do not appear related to poor insight or highly treatment-resistant OCD. The impact of OCPD on OCD treatment outcomes requires further research.

Disclosure of interest

This work did not receive funding from external sources. Over the past few years, Dr. Fineberg has received financial support in various forms from the following: Shire, Otsuka, Lundbeck, Glaxo-SmithKline, Servier, Cephalon, Astra Zeneca, Jazz pharmaceuticals, Bristol Myers Squibb, Novartis, Medical Research Council (UK), National Institute for Health Research (UK), Wellcome Foundation, European College of Neuropsychopharmacology, UK College of Mental Health Pharmacists, British Association for Psychopharmacology, International College of Obsessive-Compulsive Spectrum Disorders, International Society for Behavioural Addiction, World Health Organization, Royal College of Psychiatrists.

Type
e-Poster walk: Co-morbidity/dual pathologies and guidelines/Guidance – part 1
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S135 - S136
Copyright
Copyright © European Psychiatric Association 2017
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