TOPLINE:

Nearly 1 in 5 patients with obsessive-compulsive disorder (OCD) had comorbid obsessive-compulsive personality disorder (OCPD) in a new study, which was linked to a longer delay in treatment initiation and duration of untreated illness than having OCD alone.

METHODOLOGY:

• A study conducted in Milan, Italy, between 2022 and 2024 involved 300 patients with a primary diagnosis of OCD; 19% had comorbid OCPD.
• Outcome measures included the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Clinical Global Impression-Severity scale, and the Barratt Impulsiveness Scale.
• An age- and sex-matched sensitivity analysis was also performed, matching 56 patients with OCD alone with 55 patients with both OCD and OCPD to measure the robustness of the main findings.

TAKEAWAY:

• Patients with OCD and comorbid OCPD had a higher age at first pharmacologic treatment than those with OCD only (mean, 32.2 vs 27.5 years; P = .02).
• The duration of untreated illness was longer in the OCD plus OCPD group vs OCD-only group (mean, 9.2 vs 6.1 years; P = .03).
• The Y-BOCS obsessions subscale score was significantly higher in the OCD plus OCPD group vs the OCD-only group (mean, 14.2 vs 11.4; P = .04), although there were no between-group differences in Y-BOCS total or compulsions subscale scores.
• In the sensitivity analysis, patients with both OCD and OCPD vs those with OCD alone had a longer duration of untreated illness (mean, 11 vs 6 years; P = .03) and a higher age at first pharmacologic treatment (mean, 36 vs 26 years; P = .02).

IN PRACTICE:

“In patients with both OCD and OCPD, the ego-syntonic nature of their beliefs could be a primary reason for delayed treatment, which is known to increase the risk of inadequate treatment response and the persistence of severe symptoms,” the investigators wrote. 

“These findings underscore the critical importance of early identification and intervention in OCD patients with comorbid OCPD to improve treatment outcomes,” they added.

SOURCE:

The study was led by Nicolaja Girone, University of Milan, Milan. It was published online on March 20 in the Journal of Psychiatric Research.

LIMITATIONS:

Patients were recruited from a single tertiary clinic, potentially limiting the generalizability of the findings, and the cross-sectional design restricted conclusions regarding long-term outcomes. Residual confounding related to unmeasured factors could not be fully excluded. The type and duration of pharmacotherapy or psychotherapeutic interventions were not specifically analyzed. Additionally, the tools used in the study may not have fully captured the functional and psychosocial impairments in patients with comorbid OCPD. 

DISCLOSURES:

The study did not receive any funding. Disclosure information for the investigators is available in the original study publication.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.