The Neurobiological Foundations of Obsessive-Compulsive Personality Disorder: A Comprehensive Review

Document Type : Review Article

Authors

1 Department of Pedagogy and Psychology, Urgench State University, Urgench, Uzbekistan

2 Department of Medicine, Urgench Mamun University, Urgench, Uzbekistan

3 Department of Clinical Subjects, Tashkent State Medical University, Tashkent, Uzbekistan

4 Department of Psychology, Mamun University, Khiva, Uzbekistan

Abstract
Objective: This review aims to integrate and critically evaluate the existing neurobiological evidence concerning Obsessive-Compulsive Personality Disorder (OCPD). It synthesizes findings from neuroimaging, genetic, and neuropsychological studies to propose a distinct etiological model that differentiates OCPD from Obsessive-Compulsive Disorder (OCD).
Methods: A systematic literature search was conducted across PubMed, PsycINFO, and Google Scholar for studies published between 1990 and 2025. Keywords included “obsessive-compulsive personality disorder,” “neurobiology,” “neuroimaging,” “genetics,” and related terms. Studies were included if they provided original empirical data on the neurobiology of OCPD or its core traits. Data were narratively synthesized due to methodological diversity.
Results: Fifty-six studies met the inclusion criteria. Structural MRI findings indicate increased grey matter volume in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC). Functional MRI studies reveal hyperactivation in the DLPFC, dorsal ACC, and fronto-parietal network during tasks of cognitive control and error monitoring, alongside reduced connectivity with limbic regions. Neurochemical evidence points to dysregulation in serotonin and dopamine systems. Genetic studies show high heritability (approximately 50–78%) and potential associations with genes such as SLC6A4COMT, and DRD3. Neuropsychological profiles reflect intact planning abilities but impairments in cognitive flexibility and heightened error sensitivity.
Conclusion: OCPD is associated with a unique neurobiological profile characterized by overactive prefrontal cognitive control systems and diminished integration with emotional processing regions, rather than the fear-based circuitry typical of OCD. This “hyper-executive” model accounts for core OCPD traits such as perfectionism, rigidity, and excessive need for order. Future research should prioritize well-defined OCPD cohorts to validate this model and develop targeted, biologically informed interventions.
 

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