What is the diagnose for Thomas using the DSM-5-TR & Z-codes (ICD-10)?

Thomas, a 36 year old separated man with two children, has been referred to his employment assistance program (EAP) because he is having a difficult time in making timely decisions at work. The client was married for 10 years from the age of 25-35 and is currently separated. He has a daughter, age 7 and a son, age 5. Thomas is a college graduate who is employed as an accountant for a shipping company. He is often late with important work deadlines and he has been counseled about this a few times by his supervisor. The client has angrily complied with the request to attend the EAP program for counseling although he does not believe that anything is wrong with him. He has described himself as "so devoted to my work that I make others in my section look bad," believing that this is the reason he has been singled out for attention and referred to the employee assistance program.

Thomas states that he has worked at this company for 8 years and during that time has put in anywhere from 10 to 12 hours of work per day. He admits that he often misses deadlines but claims that "they are unreasonable deadlines for the quality of work that I have to provide." He states, "If more people in the company were like me, we would get a lot more donethere are too many lazy folks and individuals who just do not follow the rules." Thomas reports that he has had to find ways to keep these people off the work teams he is assigned to as he is not comfortable assigning tasks to them for he knows they will not be able to sufficiently meet his standards. Thomas reports that he often spends extra hours in the evening and during weekends doing work-focused activities for which he thinks his supervisor should be grateful. When asked about leisure activities Thomas reports that ensuring that his work activities are appropriately fulfilled is more important and that leisure activities are often neglected. In specific, he reports developing "very useful schedules that can really help with some of the tasks at work." He also states that his office is always perfectly neat and orderly and he says that "I know where every dollar I have ever spent went." Thomas reports that "You never know what types of crises may be coming and it is essential to have a sizable nest egg." However, he is concerned as he has been told by his boss that if he does not find a way to handle the issues at work he may lose his job. Due to this he reports that he is willing to try to work on his "need" to do everything as perfectly as possible before turning it in so he can meet the required deadlines. Thomas states he thinks this will help him to keep his job and feels this is a good initial focus to the counseling. He also reports that it may be helpful if he could learn to not hold others to the standards that he holds for himself.

On mental status examination, Thomas does not reveal any abnormalities in mood, thought processes or thought content. He reported no suicidal or homicidal ideations. He reports some anger from time to time that appears to trace back to stubbornness. He also reports some discomfort from time to time when his things in his office or apartment are out of order but states that this did not result in extreme anxiety or ritualistic behaviors. Thomas reports that his wife often tells him that his desire to "put everything in its place" and "need" (her word, Thomas states, not his) to have those around him do the same drives her crazy. He states that after 10 years of marriage she has taken the children and left and that this occurred within the past couple of months. He reports that he does not understand what her issue is because he has always been like this for as long as he can remember so it was not as though he changed suddenly. He reported that as a child he often liked to put all of his toys in order before he went to bed. However, he did not report any invasive thoughts that caused him to "have" to do this. Instead, Thomas noted that his mother was the same way and that he thinks he gets this from her. In specific, she would have him organize the clothes in his closet by color as this is what she did. The client reports that he does not know of any mental health issues in his family. The client reported that he recently had his annual examination with his family doctor and was given a clean bill of health.