242 Obsessive-Compulsive and Related Disorders
disorder), and substance use (e.g., alcohol us e disorder). However, these behaviors differ
from the compulsions of OCD in that the pers on usually derives pleasure from the activity
and may wish to resist it only beca use of its deleterious consequences.
Obsessive-compulsive personality disorder. Although obsessive-compulsive person-
ality disorder and OCD have similar names, the clinical manifestations of these disorders
are quite different. Obsessive- compulsive personality disorder is not characterized by in-
trusive thoughts, images, or ur ges or by repetitive behavior s that are performed in re-
sponse to these intrusions; instead, it in volves an enduring and pervasive maladaptive
pattern of excessive perfectionism and rigid co ntrol. If an individual manifests symptoms
of both OCD and obsessive-compulsive persona lity disorder, both diagnoses can be given.
Comorbidity 
Individuals with OCD often have other psycho pathology. Many adults with the disorder
have a lifetime diagnosis of an anxiety disord er (76%; e.g., panic disorder, social anxiety
disorder, generalized anxiety disorder, specific  phobia) or a depressive or bipolar disorder
(63% for any depressive or bipolar disorder, with the most common being major depres-
sive disorder [41%]). Onset of OCD is usually later than for most co morbid anxiety disor-
ders (with the exception of separation anxiet y disorder) and PTSD bu t often precedes that
of depressive disorders. Comorbid obsessi ve-compulsive personality disorder is also
common in individuals with OCD (e.g., ranging from 23% to 32%). 
Up to 30% of individuals with OCD also have a lifetime tic disorder. A comorbid tic
disorder is most common in males with onset of OCD in childhood. These individuals