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The neurobiology of obsessive–compulsive personality disorder: a systematic review

Published online by Cambridge University Press:  11 August 2021

Clara Marincowitz Open the ORCID record for Clara Marincowitz [Opens in a new window] ,
Christine Lochner  and
Dan J. Stein
Clara Marincowitz*
Affiliation:
South African Medical Research Council (MRC) Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
Christine Lochner
Affiliation:
South African Medical Research Council (MRC) Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
Dan J. Stein
Affiliation:
South African Medical Research Council (MRC) Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
*
*Author for correspondence: Clara Marincowitz, Email: claram@sun.ac.za
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Abstract

Background

A number of recent investigations have focused on the neurobiology of obsessive–compulsive personality disorder (OCPD). However, there have been few reviews of this literature with no detailed model proposed. We therefore undertook a systematic review of these investigations, aiming to map the available evidence and investigate whether it is possible to formulate a detailed model of the neurobiology of OCPD.

Methods

OCPD can be considered from both categorical and dimensional perspectives. An electronic search was therefore conducted using terms that would address not only OCPD as a category, but also related constructs, such as perfectionism, that would capture research on neuropsychology, neuroimaging, neurochemistry, and neurogenetics.

Results

A total of 1059 articles were retrieved, with 87 ultimately selected for abstract screening, resulting in a final selection of 49 articles focusing on neurobiological investigations relevant to OCPD. Impaired executive function and cognitive inflexibility are common neuropsychological traits in this condition, and suggest that obsessive–compulsive disorder (OCD) and OCPD may lie on a continuum. However, neuroimaging studies in OCPD indicate the involvement of specific neurocircuitry, including the precuneus and amygdala, and so suggest that OCD and OCPD may have important differences. Although OCPD has a heritable component, we found no well-powered genetic studies of OCPD.

Conclusion

Although knowledge in this area has advanced, there are insufficient data on which to base a comprehensive model of the neurobiology of OCPD. Given the clinical importance of OCPD, further work to understand the mechanisms that underpin this condition is warranted.

Keywords

Obsessive–compulsive personality disorderneurobiologyneuropsychologyneuroimagingneurochemistrygenetics
Type
Review
Information
CNS Spectrums , Volume 27 , Issue 6 , December 2022 , pp. 664 - 675
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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