Soru

A 35-year-old man is brought to the clinic by his husband for couples counseling. The husband complains that the patient is "suffocatingly rigid." For example, the patient insists on packing the dishwasher in a highly specific configuration and will unpack and repack it entirely if the husband does it "incorrectly." The patient recently received a formal warning at his accounting firm because he missed a major filing deadline; he spent three weeks formatting the spreadsheets to look "flawless" rather than submitting the adequate, finalized data on time. He refuses to delegate tasks to junior accountants, stating, "They are careless, and I am the only one who can do it exactly right." He frequently skips social events to organize his home office and refuses to throw away old, broken electronics, claiming they "might be useful someday." During the interview, the patient appears frustrated and says, "My husband is overreacting. I just have high standards. Is it a crime to want things done properly?" He denies any repetitive, intrusive thoughts or sudden urges that cause him distress. Mental status examination reveals a constricted affect and overly formal speech. Which of the following is the most likely diagnosis?