Review Question - QID 107071

The male in this scenario is obsessed with order and perfection, and most likely has an obsessive compulsive personality disorder (OCPD).

A personality trait is an enduring pattern of behavior exhibited in a wide range of persons, while a personality disorder is a pervasive, inflexible, extreme, maladaptive personality trait causing impaired functioning or subjective distress. The disorders are ego syntonic - the person has limited awareness of disorder. Personality disorders are divided into three clusters: A, B, C. In this scenario, the male has a cluster C personality disorder which is generally characterized by being worried, anxious, fearful, and are associated with anxiety disorders. Specifically, this male has OCPD due to his preoccupation with order, perfectionism, and control; it is typically ego syntonic, whereas obsessive-compulsive disorder (OCD) is ego dystonic.

Ward reviews personality disorders stating that they cannot be caused by a "major psychiatric disorder, a medical disorder, or the effects of a substance." Diagnosis typically occurs over the course of many interactions with the physician. Clues can be seen in patient's style of interaction with and their expectations from the physician.

In contrast Eddy and Walbroehl review obsessive compulsive disorder (not personality disorder) stating that serotonin may be involved in the disorder. The disorder usually appears during late adolescence affecting both male and females at similar rates. Symptoms involve thoughts that result in repetitive, ritualistic actions that interfere with the patient's life. Pharmacologic treatment consists of clomipramine or SSRI's and behavioral therapy, shown to be effective, may also be combined or used alone.

Incorrect Answers:
Answer 1: Schizoid personality disorder is characterized by voluntary social withdrawal (are content with the social isolation) and have limited emotional expression with a main defense mechanism of projection.

Answer 2: Narcissistic personality disorder is characterized by grandiosity, need for admiration, sense of entitlement, lacks empathy, and reacts to criticism with rage.

Answer 4: Paranoid personality disorder is characterized by excessive distrust and suspiciousness with a main defense mechanism of projection.

Answer 5: Obsessive compulsive disorder is characterized by ritualistic behavior and abnormal behaviors that are often completed to relieve anxiety related to some underlying cause in the patient's life. This can be excessive hand washing or excoriation disorder however the patient is aware that these behaviors are odd and have insight to their condition.