2026 ECNP Congress

PS03-3030

Associations between obsessive-compulsive personality disorder and sleep quality in individuals with anxiety and mood disorders

Agne Stanyte — A. Podlipskyte, J. Gecaite-Stonciene, V. Steibliene, J. Burkauskas · Neuroscience Institute- Lithuanian University of Health Sciences, Laboratory of Behavioral Medicine, Palanga, Lithuania

2026 ECNP Congress

Background

Obsessive-compulsive personality disorder (OCPD) is common in individuals with anxiety and mood disorders (AMD). OCPD has been linked to shorter and more disrupted sleep patterns in individuals with insomnia [1], and associated with specific sleep disorders [2] in non-psychiatric samples. However, sleep disturbances are one of the most commonly reported symptoms among individuals with AMD, with reported difficulties of initiating or maintaining sleep, as well as reported worse overall sleep experience and sleep quality [3]. Dysfunctional personality patterns that are present in OCPD could be enhancing the difficulties with sleep in AMD, however, the associations between these variables have not been studied in individuals with AMD. Therefore, the aim of our study was to investigate the associations between OCPD and subjective sleep quality in individuals with AMD.

Methods

This cross-sectional study investigated 227 individuals (77.5 percent women, mean age 40.2±11.9) attending a Stress-related disorders day care unit of the Palanga Hospital at Neuroscience Institute of the Lithuanian University of Health Sciences. Sociodemographic and clinical information including diagnosis (as defined by the Mini International Neuropsychiatric Interview), medication use, and history of smoking were collected. OCPD traits were evaluated using the observer-rated Compulsive Personality Assessment Scale (CPAS) [4]. The diagnosis of OCPD was defined as a score of three (severe) or four (very severe) on at least four of the CPAS items. Sleep quality and characteristics were assessed using Pittsburgh Sleep Quality Index (PSQI), with a higher score indicating worse sleep quality. Two-tailed Student’s test of Fisher’s χ2 test was applied to compare sociodemographic, clinical, and sleep quality in individuals with AMD with and without OCPD. A multivariable regression analysis was used to examine the association between the presence of OCPD and sleep quality, adjusted by age, sex, history of smoking, and current medication use.

Results

All study participants had such diagnoses as follows: mood disorders, 57 individuals (25.1%); anxiety disorders, 54 individuals (23.8%); comorbid anxiety and mood disorders, 116 individuals (51.1%). Out of 227 participants, 45 (19.8%) individuals fulfilled the operational criteria for OCPD (77.8% female). Participants with OCPD were more likely to have a comorbid AMD diagnosis (66.7% vs. 48.9%; p=0.015). Participants with OCPD took longer time to fall asleep (44.82±36.42 vs. 33.01±27.2; p=0.016), had more daytime dysfunction (2.2±0.69 vs. 1.89±0.9; p=0.031), and reported overall worse sleep quality (11.27±3.69 vs. 9.85±3.88; p=0.028) as compared to the individuals without OCPD. A multivariable regression analysis showed that the presence of OCPD was associated with worse sleep quality after controlling for age, gender, smoking history, and current medication use (b=0.168; p=0.014).

Conclusions

Overall, individuals with AMD and comorbid OCPD reported more sleep problems and had worse sleep quality than individuals without comorbid OCPD. The presence of OCPD was associated with worse sleep quality even after controlling for possible confounders. The results show the importance of dysfunctional personality patterns on subjective sleep quality. The presence of OCPD could have significant clinical implications for sleep quality in individuals with AMD.

References

  1. Petrov, M.E., S.E. Emert, and K.L. Lichstein, Obsessive-compulsive personality disorder features and response to behavioral therapy for insomnia among patients with hypnotic-dependent insomnia. Behav Sleep Med, 2019. 17(6): p. 740-752.
  2. Luca, A., et al., Obsessive-compulsive personality disorder in rapid eye movement sleep behavior disorder. Sci Rep, 2022. 12(1): p. 2401.
  3. Shen, J., J. Barbera, and C.M. Shapiro, Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev, 2006. 10(1): p. 63-76.
  4. Fineberg, N.A., et al., Does obsessive-compulsive personality disorder belong within the obsessive-compulsive spectrum? CNS Spectr, 2007. 12(6): p. 467-82.