The Perfect Employee Who Never Completes His Work In Time
An interesting case I found On Medscape Student Quiz section.
A 52-year-old man is sent to see a psychiatrist after he is disciplined at his job because he consistently turns in his assignments late. He insists that he is not about to turn in anything until it is “perfect, unlike all of my colleagues.” He has few friends because he annoys them with his demands for “precise timeliness” and because of his lack of emotional warmth. This has been a lifelong pattern for the patient, though he refuses to believe the problems have anything to do with his personal behavior. Which of the following is the most likely diagnosis for this patient?
Obsessive-compulsive personality disorder
Borderline personality disorder
Bipolar disorder, mixed state
[spoiler] Ans: Obsessive-compulsive personality disorder. The essential feature of obsessive-compulsive personality disorder is a preoccupation with perfection, orderliness, and control. Individuals with this disorder lose the main point of an activity and miss deadlines because they pay too much attention to rules and details and are not satisfied with anything less than “perfection.” As in other personality disorders, symptoms are ego-syntonic and create interpersonal, social, and occupational difficulties.
Obsessive-compulsive disorder is differentiated from obsessive-compulsive personality disorder by the presence of obsessions and compulsions. In addition, patients with symptoms of obsessive-compulsive disorder view them as ego-dystonic.
Patients with borderline personality disorder present with a history of pervasive instability of mood, relationships, and self-image beginning by early adulthood. Their behavior is often impulsive and self-damaging.
Patients with bipolar disorder present with problems of mood stability; mood may be depressed for several weeks at a time, then euphoric. [/spoiler]
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