[4] The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

[3] Obsessive–compulsive personality disorder (OCPD) is marked by an excessive obsession with rules, lists, schedules, and order; a need for perfection[11] that interferes with efficiency and the ability to complete tasks; a devotion to productivity that hinders interpersonal relationships and leisure time; rigidity and zealousness on matters of morality and ethics; an inability to delegate responsibilities or work to others; restricted functioning in interpersonal relationships; restricted expression of emotion and affect; and a need for control over one's environment and self.

On the other hand, the symptoms that were most likely to change over time were the miserly spending style and the excessive devotion to productivity.

The perfectionism and the extremely high standards that they establish are to their detriment and may cause delays and failures to complete objectives and tasks.

For example, a person may write an essay and, believing that it fell short of perfection, continues rewriting it, missing the deadline or even failing to complete the task.

OCPD is controlled and egosyntonic, whereas work addiction is uncontrolled and egodystonic, and the affected person may display signs of withdrawal.

[14] Individuals with OCPD are overconscientious, scrupulous and rigid, and inflexible on matters of morality, ethics and other areas of life.

Whenever this dichotomous view of the world cannot be applied to a situation, this causes internal conflict as the person's perfectionist tendencies are challenged.

They have little spontaneity when interacting with others, and ensure that their speech follows rigid and austere standards by excessively scrutinising it.

They filter their speech for embarrassing or imperfect articulation, while they maintain a high bar for what they consider to be acceptable.

While conscientiousness is a desirable trait generally, its extreme presentation for those with OCPD leads to interpersonal problems.

The inability to accept differences in belief or behaviors from others often leads to high conflict and controlling relationships with coworkers, spouses, and children.

[19] The DSM-5 also includes an alternative set of diagnostic criteria as per the dimensional model of conceptualizing personality disorders.

The patient must also meet the general criteria C through G for a personality disorder, which state that the traits and symptoms being displayed by the patient must be stable and unchanging over time with an onset of at least adolescence or early adulthood, visible in a variety of situations, not caused by another mental disorder, not caused by a substance or medical condition, and abnormal in comparison to a person's developmental stage and culture/religion.

[23] Regardless of similarities between the OCPD criteria and the obsessions and compulsions found in OCD, there are discrete qualitative dissimilarities between these disorders, predominantly in the functional part of symptoms.

In contrast, the trait of perfectionism may improve the outcome of treatment as patients are likely to complete homework assigned to them with determination.

[25] There are considerable similarities and overlap between autism spectrum disorder (ASD) and OCPD,[7] such as list-making, inflexible adherence to rules, and obsessive aspects of ASD, although the latter may be distinguished from OCPD especially regarding affective behaviors, worse social skills, difficulties with Theory of Mind and intense intellectual interests, e.g. an ability to recall every aspect of a hobby.

[26] A 2009 study involving adult autistic people found that 32% of those diagnosed with ASD met the diagnostic requirements for a comorbid OCPD diagnosis.

A researcher in 1949 described the behavior of the average "anorexic girl" as being "rigid" and "hyperconscious", observing a tendency to "[n]eatness, meticulosity, and a mulish stubbornness not amenable to reason [which] make her a rank perfectionist.

Samples that had the childhood traits of rigidity, extreme cautiousness, and perfectionism endured more severe food restriction and higher levels of exercise and underwent longer periods of underweight status.

More research on the relationship between the disorders is thought to help uncover causes and develop treatments for patients.

[24] Moreover, OCPD has been found to be very common among some medical conditions, including Parkinson's disease and the hypermobile subtype of Ehler-Danlos syndrome.

[36] Estimates for the prevalence of OCPD in the general population are 3%,[37] making it the most common personality disorder.

Current evidence is inconclusive as to whether OCPD is more common in men than women, or in equal rates among sexes.

[3] A study of data collected in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions looked specifically for seven personality disorders as defined by the DSM-IV.

[38] In 1908, Sigmund Freud named what is now known as obsessive–compulsive or anankastic personality disorder "anal retentive character".

[39][40] He identified the main strands of the personality type as a preoccupation with orderliness, parsimony (frugality), and obstinacy (rigidity and stubbornness).

[43] In the book Contributions to the theory of the anal character, Karl Abraham noted that the core feature of the anal character is being perfectionistic, and he believed that these traits will help an individual in becoming industrious and productive, whilst hindering their social and interpersonal functioning, such as working with others.

[43] OCPD was included in the first edition of the Diagnostic and Statistical Manual of Mental Disorders in 1952 by the American Psychiatric Association under the name "compulsive personality".