A 48-year-old male accountant presents at his wife's insistence. She reports he is 'impossible to live with' due to his extreme rigidity about household routines, refusal to delegate any household tasks because no one does them 'correctly,' and devotion to work that excludes leisure and friendships. He creates exhaustive to-do lists and becomes irritable when family members deviate from his schedules. He describes himself as 'thorough and responsible' and does not understand why his wife is upset. He denies intrusive, unwanted thoughts, does not perform repetitive rituals to reduce anxiety, and does not view his behavior as excessive or unreasonable.