Good Psychiatric Management for Obsessive–Compulsive Personality Disorder
2021
Obsessive–compulsive personality disorder (OCPD) is a prevalent personality disorder that frequently presents in health care settings with other psychiatric comorbidities. However, no OCPD treatment guidelines for a general mental health clinician have been proposed. This review summarizes current, clinically relevant knowledge about OCPD and introduces a pragmatic and accessible treatment model: Good Psychiatric Management (GPM) for OCPD. GPM for OCPD offers clinicians a straightforward framework for understanding and treating OCPD patients, informed by eight principles: (1) diagnostic disclosure with assessment of the effect of perfectionism and rigidity on occupational and social life, (2) psychoeducation regarding the role of over-reliance on overcontrol as a core mechanism of instability, (3) focus on life outside of treatment as a grounds for personal growth, (4) use of corrective experiences to dispel rigidly held beliefs and promote more flexible personality functioning, (5) managing comorbidities, (6) use of multimodal treatments, (7) managing safety using general suicide risk assessment, and (8) conservative pharmacological management. Guided by up-to-date knowledge about OCPD, an accessible OCPD conceptualization, and GPM’s eight principles, the generalist mental health clinician can help their patient to build a meaningful life beyond OCPD symptoms.
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