Journal of Anxiety Disorders 33 (2015) 15–24 Contents lists available at ScienceDirect Journal of Anxiety Disorders The correlates of obsessive–compulsive, schizotypal, and borderline personality disorders in obsessive–compulsive disorder Isabela A. Melca a , Murat Yücel b , Mauro V. Mendlowicz c , Ricardo de Oliveira-Souza d , Leonardo F. Fontenelle a,b,d,* a Anxiety and Obsessive-Compulsive Spectrum Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil b School of Psychological Sciences & Monash Biomedical Imaging Facility, MONASH University, Australia c Department of Psychiatry and Mental Health, Fluminense Federal University, Brazil d D’Or Institute for Research and Education (IDOR), Brazil a r t i c l e i n f o Article history: Received 26 January 2015 Received in revised form 12 April 2015 Accepted 13 April 2015 Available online 22 April 2015 Keywords: Obsessive–compulsive disorder Personality disorders Borderline personality disorder Obsessive–compulsive personality disorder Schizotypal personality disorder Antisocial personality disorder a b s t r a c t We assessed correlates of obsessive–compulsive (OCPD), schizotypal (SPD) and borderline (BPD) per- sonality disorders in 110 obsessive–compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non- planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of “low-order” behaviors (i.e., touching), lower low-planning impulsivity and greater “behavioral” compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symme- try and hoarding, more motor and non-planning impulsivity, and greater “cognitive” compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples. © 2015 Published by Elsevier Ltd. 1. Introduction The DSM-5 defines personality disorder (PD) as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and lead to distress or impairment” (APA, 2013). Although several studies have shown that patients with obsessive–compulsive disorder (OCD) display an increased preva- lence of several PDs in clinical (Baer & Jenike, 1992; Maina, Albert, Salvi, Pessina, & Bogetto, 2008; Pinto, Mancebo, Eisen, Pagano, & Rasmussen, 2006) and epidemiological settings (Torres et al., 2006), it is unclear whether PDs or associated traits predispose to, or are a consequence of OCD. One study found that individuals with mixed avoidant, compulsive and dependent features were more likely to have a longer duration of illness leading authors to suggest that lifestyle changes secondary to OCD might end up misshaping and * Corresponding author at: Rua Visconde de Pirajá, 547, Sala 617., Ipanema, CEP: 22410-003 Rio de Janeiro, Brazil. Tel.: +55 21 22394919; fax: +55 21 22394919. E-mail address: lfontenelle@gmail.com (L.F. Fontenelle). disarranging the personality structure of OCD patients who had no premorbid PDs (Baer et al., 1990). The mitigation of PD traits after successful treatment of OCD has been seen as an evidence suppor- ting the later hypothesis (Ricciardi et al., 1992). However, it has also been demonstrated that one specific PD (obsessive–compulsive personality disorder or OCPD) predicted OCD relapse in the long- term (Eisen et al., 2013). Other studies suggest that the rates of specific PDs in OCD do not differ from those seen in other anxiety disorders (Albert, Maina, Forner, & Bogetto, 2004; Pena-Garijo, Edo Villamon, Melia de Alba, & Ruiperez, 2013). Despite the long-standing discussion on the primary vs. sec- ondary nature of PDs in OCD, very few studies have attempted to clarify or characterize the socio-demographic and clinical corre- lates of different PDs in OCD. In general, these studies typically focus on a single PD, most frequently obsessive–compulsive (Coles, Pinto, Mancebo, Rasmussen, & Eisen, 2008; Diaferia et al., 1997; Eisen et al., 2006; Garyfallos et al., 2010; Gordon, Salkovskis, Oldfield, & Carter, 2013; Lochner et al., 2011; Starcevic et al., 2013) or schizotypal PDs (Jenike, Baer, Minichiello, Schwartz, & Carey, 1986; Poyurovsky, 2008; Stanley, Turner, & Borden, 1990). This limited focus ignores the fact that in several cases, individuals may ful- fill diagnostic criteria for more than one PD at any given time. http://dx.doi.org/10.1016/j.janxdis.2015.04.004 0887-6185/© 2015 Published by Elsevier Ltd.