Question:medium
Mr. K was brought to a psychiatrist by his friend, saying that Mr. K needs everything to be in perfect order and has difficulty in getting rid of things stored with him, both of which are affecting his work quality. He is a perfectionist. However, Mr. K denies such complaints. What is the diagnosis?
Mr. K was brought to a psychiatrist by his friend, saying that Mr. K needs everything to be in perfect order and has difficulty in getting rid of things stored with him, both of which are affecting his work quality. He is a perfectionist. However, Mr. K denies such complaints. What is the diagnosis?
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Perfectionism, orderliness, rigidity, and hoarding-like difficulty discarding items with poor insight = OCPD.
Updated On: May 14, 2026
- Narcissistic personality
- Obsessive Compulsive Personality Disorder
- Paranoid delusion
- Dependent personality
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The Correct Option is B
Solution and Explanation
Step 1: Understanding the Question:
The clinical scenario presents a patient with a long-standing pattern of perfectionism, preoccupation with orderliness, and inability to discard useless items (hoarding-like behavior). A key diagnostic feature is the patient's lack of insight or denial of the problem.
Step 2: Detailed Explanation:
Obsessive-Compulsive Personality Disorder (OCPD): This is a Cluster C personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.
Ego-syntonic vs. Ego-dystonic: A hallmark of OCPD is that the traits are "ego-syntonic," meaning the individual views their behavior as correct, rational, and desirable. This explains why Mr. K denies the complaints made by his friend. In contrast, Obsessive-Compulsive Disorder (OCD) is typically "ego-dystonic," where the patient is distressed by their obsessions and compulsions.
Clinical Features: Patients with OCPD are often over-devoted to work and productivity, excluding leisure activities. Their perfectionism often interferes with task completion because their own overly strict standards are not met.
Hoarding in OCPD: As mentioned in the stem, the inability to discard worn-out or worthless objects even when they have no sentimental value is a recognized criterion for OCPD.
Interpersonal Impact: While these individuals may be highly successful in certain structured environments, their rigidity and "my way or the highway" attitude frequently lead to significant conflict in social and occupational settings.
Step 3: Final Answer:
Mr. K's ego-syntonic perfectionism and preoccupation with order, which he does not perceive as problematic, are characteristic of Obsessive-Compulsive Personality Disorder (OCPD).
The clinical scenario presents a patient with a long-standing pattern of perfectionism, preoccupation with orderliness, and inability to discard useless items (hoarding-like behavior). A key diagnostic feature is the patient's lack of insight or denial of the problem.
Step 2: Detailed Explanation:
Obsessive-Compulsive Personality Disorder (OCPD): This is a Cluster C personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.
Ego-syntonic vs. Ego-dystonic: A hallmark of OCPD is that the traits are "ego-syntonic," meaning the individual views their behavior as correct, rational, and desirable. This explains why Mr. K denies the complaints made by his friend. In contrast, Obsessive-Compulsive Disorder (OCD) is typically "ego-dystonic," where the patient is distressed by their obsessions and compulsions.
Clinical Features: Patients with OCPD are often over-devoted to work and productivity, excluding leisure activities. Their perfectionism often interferes with task completion because their own overly strict standards are not met.
Hoarding in OCPD: As mentioned in the stem, the inability to discard worn-out or worthless objects even when they have no sentimental value is a recognized criterion for OCPD.
Interpersonal Impact: While these individuals may be highly successful in certain structured environments, their rigidity and "my way or the highway" attitude frequently lead to significant conflict in social and occupational settings.
Step 3: Final Answer:
Mr. K's ego-syntonic perfectionism and preoccupation with order, which he does not perceive as problematic, are characteristic of Obsessive-Compulsive Personality Disorder (OCPD).
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