Recommended first-line treatment options for managing Obsessive-Compulsive Personality Disorder (OCPD) in primary care:
The provided UK guideline excerpts specifically address Obsessive-Compulsive Disorder (OCD) and Body Dysmorphic Disorder (BDD), but do not explicitly cover Obsessive-Compulsive Personality Disorder (OCPD). However, given the close relation and typical clinical practice, initial management in primary care for OCPD generally involves psychological interventions.
For OCD, which shares some features with OCPD, first-line treatments include low intensity psychological treatments such as brief individual cognitive behavioural therapy (CBT) including exposure and response prevention (ERP), delivered via self-help materials, telephone, or group formats, especially when functional impairment is mild NICE CG31.
Where psychological treatment is declined or ineffective, selective serotonin reuptake inhibitors (SSRIs) may be considered, with careful monitoring for adverse effects NICE CG31.
Therefore, in primary care, the recommended first-line approach for OCPD would likely be to offer low intensity CBT-based psychological interventions tailored to the patient's needs and preferences, with consideration of pharmacological treatment (SSRIs) if psychological interventions are not feasible or effective, and referral to specialist services if there is significant impairment or poor response.