Which diagnosis best fits duration, episodicity, and exclusions?
A
Obsessive-compulsive personality disorder (OCPD)
Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
AA. Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
BA. Persistent deficits in social communication/interaction across multiple contexts (≥3 components: social-emotional reciprocity; nonverbal communicative behaviours; developing/maintaining relationships) B. Restricted, repetitive patterns of behaviour/interests/activities (≥2 of: stereotyped/repetitive motor movements; insistence on sameness/inflexible routines; highly restricted interests; hyper/hyporeactivity to sensory input) C. Symptoms present in early developmental period (may not fully manifest until social demands exceed capacity)
Common specifiers
AMild / Moderate / Severe
BWith/without accompanying intellectual impairment; With/without accompanying language impairment; Associated with a known medical or genetic condition; Associated with another neurodevelopmental, mental, or behavioural disorder
Differential flags
AOCD (ego-dystonic intrusive obsessions + compulsions; not a personality style); Narcissistic PD (perfectionism driven by need for admiration); ASD (rigidity is neurodevelopmental; different onset and profile)
BADHD (comorbid in ~50%; social deficits not as pervasive; no RRBs - code both when criteria independently met); Social anxiety disorder (fear of negative evaluation; social motivation and desire intact); Social (pragmatic) communication disorder (social deficits without RRBs - mutually exclusive with ASD)