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OCPD versus OCD

June 23, 2008

My psychiatrist often criticizes the DSM. However, I do sometimes wonder about him. For instance, two visits ago, he said that he thought I had OCPD (obsessive-compulsive personality disorder), not OCD. When I reminded him of my childhood problems, he then agreed that it sounds like OCD. His explanation was that OCPD preoccupations are egosyntonic. When I pointed out that preoccupations in Asperger’s are also egosyntonic, he responded by saying that the diagnoses are inexact anyway (which, of course, is true). However, overall, I like the guy. In fact, I think he is also an aspie. In any event, he seems to believe once again that I have Asperger’s with OCD, not with OCPD.

My psychiatrist and I are are both pragmatists, which is one of the reasons I like him. I do not look at autism, OCD, and ADHD as “things” but as relative categories, with no clearly determined etiologies or causes. To him, a diagnosis is only useful if it can help the person. Otherwise, it is a waste of time. In other words, if a diagnosis of ADHD can assist a person in some area, then it may be useful to give the person that diagnosis.

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One Comment leave one →
  1. Anonymous permalink
    June 24, 2008 12:04 am

    Yes, personality disorders are a problem or pattern of behaviour “from early adulthood” (which can be as young as 15). I didn’t know that the “personality disorder” version of obsessive behaviour was ego-syntonic. Have you experienced a qualiatitive difference between your Asperger pre-occupations and the OC(P?)D pre-occupations? If so, would this be significant in diagnostics, and in real life?

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