Personality Disorder

Question 1

ESSENCE

Answer 1

When personality traits are intense enough to cause distress or impairment of social/occupational functioning

Question 2

Cluster A disorders

Answer 2

• Paranoid
• Schizoid
• Schizotypal

Question 3

Cluster A traits

Answer 3

Avoidance, rigidity, impairment of reality testing

Question 4

Cluster B disorders

Answer 4

• Dissocial
• Emotionally unstable (impulsive/borderline)
• Histrionic
• Narcissistic

Question 5

Cluster B traits

Answer 5

Antisocial attitudes, impulsivity, emotional dysregulation

Question 6

Cluster C disorders

Answer 6

• Anxious (avoidant)
• Dependent
• Anankastic

Question 7

Cluster C traits

Answer 7

Avoidance, preoccupied anxiety

Question 8

Paranoid - description

Answer 8

Sensitive, suspicious, preocupied with conspiratorial explanations, self-referential, distrust of others

Question 9

Schizoid - description

Answer 9

Emotionally cold, detachment, lack of interest in others, excessive introspection and fantasy

Question 10

Schizotypal - description

Answer 10

Interpersonal discomfort with peculiar ideas, perceptions, appearance and behaviour

Question 11

Dissocial - description

Answer 11

Callous lack of concern for others, irresponsibility, irritability, aggression, inability to maintain enduring relationships, disregard and violations of others rights, childhood conduct disorder

Question 12

Emotionally unstable impulsive type - description

Answer 12

Inability to control anger or plan, with unpredictable affect and behaviour

Question 13

Emotionally unstable borderline type - description

Answer 13

Unclear identify, intense and unstable relationships, unpredictable affect, threats or acts of self-harm, impulsivity

Question 14

Histrionic - description

Answer 14

Self-dramatisation, shallow affect, egocentricity, craving attention and excitement, manipulative behaviour

Question 15

Narcissistic - description

Answer 15

Grandiosity, lack of empathy, need for admiration

Question 16

Anxious (avoidant) - description

Answer 16

Tension, self-consciousness, fear of negative evaluation by others, timid, insecure

Question 17

Anakastic - description

Answer 17

Doubt, indecisiveness, caution, pedantry, rigidity, perfectionism, preoccupation with orderliness and control

Question 18

Dependent - description

Answer 18

Clinging, submissive, excess need for care, feels helpless when not in relationship

Question 19

INVESTIGATIONS

Answer 19

• Self reported questionaires such as
• Structured clinical interview with patient
• Structured clinical interview with informant

Question 20

MANAGEMENT

General strategy

Answer 20

• Joint and realistic goals with long term view
• Psychological and practical support
• Monitoring and supervision
• Intervening in crises
• Increasing motivation and compliance
• Treating comorbid axis 1 disorders
• Giving practical support (housing, finance, childcare)
• Potential for pharmacology

Question 21

MANAGEMENT

Medication indication

Answer 21

Development of comorbid mental illness

Question 22

MANAGEMENT

Medication

Answer 22

• Antipsychotics
  
  • Cluster B (particularly borderline) and cluster A
• Antidepressants
  
  • Impulsive, depressed or self-harming patient, and in cluster C disorders
• Anticonvulsants and lithium
  
  • Where affective instability or impulsivity