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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416662/

OCD being an anxiety disorder and OCPD being a personality disorder it is entirely possible that these two can be present on the same patient.

Autism, e.g Aspergers Syndrome and ADHD have some similarities but are distinct disorders.

We learn at university that people with Aspergers are frequently obsessive.

Based on Occam's Razor "Pluralitas non est ponenda sine necessitate" Psychiatrists and Neuropsychologists are intently parsimonious in diagnosing a patient with multiple disorders even if the examinee meets the criteria, is indeed experiencing the symptom, has the equivalent behaviour. And we are taught at university just that.

Is there any case in which the behaviour of the examinee undoubtedly suggests comorbidity of OCD,OCPD, ASD and ADHD mixed type maybe even along with an entirely distinct disorder like dysthimia? How exactly are these examinees' behaviours? As a medicine student professors do not answer these questions in their lectures ( one reason I am most probably converting to Law since they are slightly more open there).

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  • $\begingroup$ I think the tags are suitable as Neurodevelopmental disorders and OCD, OCPD are in fact related directly to the cognitive function, as behaviour is directly related to it. The basis for mental disorders are neurobiology and the cognitive function in itself. Learning is related because the cognitive function itself is likely learned, taught. As a mainly acquired state and not a genetic one. ncbi.nlm.nih.gov/pmc/articles/PMC3384464 linguisticsociety.org/resource/faq-how-do-we-learn-language. Society does in fact teach and these disorders incommode the same society. $\endgroup$ – George Ntoulos Aug 18 at 23:58
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    $\begingroup$ I think the new tags were much better. You keep asking for advice on your questions and then rejecting the feedback you get. Very rude. $\endgroup$ – Bryan Krause Aug 19 at 0:41
  • $\begingroup$ @BryanKrause Everyone is entitled to their own opinions. I simply want more than just advice. Advice and an explanation of it. It is simply not incentive compatible to give ears to everyone's opinions. Everyone will serve their best interests. This is what they must do. this is what is right, needed and necessary. A nice way to choose which opinions serve you is to ask for an explanation. This way only what is well-founded and correct in formal logic will be attended to. People who do not care enough to explain should not opine. What I got is "I feel that..." Which lacks an explanation why?. $\endgroup$ – George Ntoulos Aug 19 at 1:26
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    $\begingroup$ Perhaps I can explain my point better, as you suggest. It is true these disorders are related to cognitive functioning but so are a lot of things in psychology. After all cognition underlies most psychological processes. The point is that the question mostly deals with disorders which fall in the field of clinical/abnormal psychology. Your question focuses primarily on comorbidity which is part of diagnostic practice in the fields that I mentioned. That is why I suggest the tags "Clinical psychology", "Abnormal psychology" and "Personality disorders". $\endgroup$ – Halls of Justice Aug 19 at 12:43
  • $\begingroup$ @HallsofJustice Thank you earnestly for reasoning and explaining your opinion. My problem with personality disorders are that only OCPD is a personality disorder and OCPD is not the core of the question. The core of the question is comorbidity and parsimony. I am going to keep clinical and abnormal psychology along with neuroscience(neurobiology), cognitive psychology and learning. I am going to sacrifice cognitive-neuroscience and social-psychology. $\endgroup$ – George Ntoulos Aug 19 at 19:15
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I found your question hard to answer because of the multiple disorders involved. I hope my answers contains some information that is usefull to you. However, it is likely not the satifsying answers you are looking for.

According to Hansen, Oerbeck, Skirbekk, Petrovski, & Kristensen (2018) about 21 percent of children with neurodevelopmental disorders (ND) have one comorbid disorder in the category of neurodevelopmental disorders. For ADHD and Autism Spectrum Disorder (ADS), tic disorder was the most common ND. 36% of ADHD patients had tic disorder as well and 44% ASD patients had a tic disorder. As for OCD, 3.3% of the patients with ADHD also had OCD and 4.0% of the patients with ASD had OCD as well. This study did not investigate the OCPD as a possible comorbid disorder for neurodevelopmental disorders. After doing some more searching, I unfortunately could not find much information about OCPD in relation to Neurodevelopmental disorders and the specific example your provided (OCD, OCDP, ADHD and ADS). However, that does not mean it is not possible, in practice all kinds of comorbidities can occur. The behavior of these patients would likely reflect the symptoms of all the disorders present in the patient.

A big problem with our current understanding/diagnosis of disorders is that most of the disorders are categorized based on their symptoms (e.g. DSM V). In practice symptoms between disorders heavily overlap resulting in comorbidity for most patients (Nolen-Hoeksema, 2014). It is often mandatory to diagnose multiple disorders. For example, if the patient meets both the criteria for ADHD and Autism Spectrum Disorder, then both disorders need to be diagnosed, same goes for OCD and OCPD (see DSM V, Chapters about Neurodevelopmental Disorders and Personality Disorders). Sometimes patients are believed to have "hybrid disorders" (multiple symptoms of multiple disorders). Therefore, it would be better to classify disorders according to their causes instead of the symptoms. That would be the first step in truly explaining disorders instead of simply describing them (Davey, 2014).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Davey G. (2014). Psychopathology: Research, Assessment & Treatment in Clinical Psychology (2nd ed). British Psychological Association and John Wiley & Sons LTD.

Hansen, B., Oerbeck, B., Skirbekk, B., Petrovski, B., & Kristensen, H. (2018). Neurodevelopmental disorders: Prevalence and comorbidity in children referred to mental health services. Nordic Journal of Psychiatry, 72(4), 285-291. doi:10.1080/08039488.2018.1444087

Nolen-Hoeksema, S. (2014). (Ab)normal psychology (6th ed.). New York: McGraw-Hill Education

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  • $\begingroup$ Thank you earnestly for your answer. My question was more specific and less about statistics. Exactly how is the behaviour;i.e which are the symptoms, of an examinee undoubtedly meeting the criteria to be diagnosed with Asperger's Syndrome, ADHD mixed type, OCD and OCPD, maybe even an unrelated disorder like Dysthymia. It is often mandatory to diagnose multiple disorders. But due to symptoms between disorders heavily overlapping(being common). Psychiatrist and Neuropsychologists are intently parsimonious. Even if DSM-V strongly suggests the diagnosis of multiple disorders in such a case. $\endgroup$ – George Ntoulos Aug 23 at 14:51
  • $\begingroup$ The professionals who have the capacity to do so are extremely reluctant to do so. $\endgroup$ – George Ntoulos Aug 23 at 14:52
  • $\begingroup$ I see, is it true then that you are looking more for case studies that come from clinical practice? $\endgroup$ – Halls of Justice Aug 23 at 15:35
  • $\begingroup$ Not so much I do not want to know that there have been instances, I am sure there have been instances. I want to know exactly how was the behaviour of those people that curbed the proffesionals' parsimony to diagnose multiple disorders. $\endgroup$ – George Ntoulos Aug 23 at 15:50
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    $\begingroup$ Mm, I see perhaps someone else can offer a better response to that question! $\endgroup$ – Halls of Justice Aug 23 at 17:37

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