Obsessive-Compulsive (Anankastic) Personality Disorder in the ICD-11: A Scoping Review

Julija Gecate-Stonciene, Christine Lochner, Clara Marincowitz, Naomi Fineberg, Dan J. Stein

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Abstract

Introduction: With the shift from a categorical to a dimensional model, ICD-11 has made substantial changes to the diagnosis of
personality disorders (PDs), including obsessive-compulsive (anankastic) personality disorder (OCPD). The ICD-11 PD model proposes
a single diagnosis of PD with specifications regarding severity and domains. However, a systematic overview of ICD-11 anankastia
is lacking. In this review we address the reformulation of the OCPD diagnosis in the ICD-11, and draw comparisons with the DSM-5,
with a particular focus on diagnostic validity and clinical utility. We hypothesized that the ICD-11 PD model is a diagnostically valid
and clinically useful framework to assess those with OCPD, with specific emphasis on the anankastia domain as the primary trait
qualifier.
Methods: Literature published from 2010 to 2020 was systematically searched using the PubMed/MEDLINE, PsychInfo, Cochrane, and
Web of Sciences search engines, in order to find all articles that addressed ICD-11 anankastia. Relevant articles were collated, and
themes of these articles subsequently extracted. To check for methodological quality, the NICE checklist was used.
Results: Out of the 264 publications identified, 19 articles were included in this review. Four themes were identified, namely (a)
overlap of DSM-5 OCPD with the ICD-11 PD model, (b) the factorial structure of the ICD-11 PD model with respect to the anankastia
domain, (c) the clinical utility of the ICD-11 PD model, and (d) comparison of the ICD-11 PD model of anankastia with the DSM-5
alternative model for OCPD.
Conclusions: The ICD-11 anankastia domain overlaps with DSM-5 OCPD traits, and the factor analyses of the ICD-11 PD model further
support the diagnostic validity of this domain. There is some limited support for the clinical utility of the ICD-11 PD model of
anankastia but further studies are needed, including of its relationship to obsessive-compulsive and related disorders.
Original languageEnglish
Article number646030
Number of pages10
JournalFrontiers in Psychiatry
Volume12
DOIs
Publication statusPublished - 16 Mar 2021

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