A key difference in OCPD and OCD is that OCPD is considered ego-syntonic and people with OCPD do not see their behavior and preoccupation as problematic, whereas OCD is ego-dystonic and people with OCD are acutely aware of how their affliction harms them.

Another difference includes that the underlying motivations behind obsessive-compulsive behaviors. Those with OCPD aim to have control over the environment, whereas individuals with OCD engage in compulsive behaviors to mitigate distress from obsessions.