Personality disorder Flashcards
Define personality disorder.
Enduring, deeply pervasive and inflexible patterns of experience and behavior, which are maladaptive in the individual/s culture and therefore cause distress and impairment of work and psychosocial functioning.
What is the aetiology of personality disorders.
Some genetic contribution.
Early adversity contributes to development: social stressor, child abuse, dysfunctional family.
Summarise the epidemiology of personality disorder.
Symptoms begin late in adolescent years. 5% of population and 40% of psychiatric patients have a PD.
What are the three clusters for symptoms of personality disorder?
- Odd/Eccentric
- Dramatic/Emotional
- Fearful/Anxious
What are the subtypes of odd/eccentric personality disorder traits?
Paranoid
Schizoid
What are some paranoid personality disorder symptoms?
- Sensitive to setbacks
- Suspicious of intentions
- Bears grudges
- Suspicious of partner fidelity
- Self importance
- Conspirational view of events
What are some schizoid personality disorder symptoms?
- Emotional coldness
- Few activities give pleasure
- Limited capacity to express feelings
- Indifference to praise or criticism
- Little interest in sex
- Prefer solitary activities
- Preoccupied with fantasy
- Insensitive to social norms
- Uninterested in close friends.
What are the subtypes of dramatic/emotional personality disorder traits?
Histrionic
Dissocial
Emotionally unstable (impulsive type)
Emotionally unstable (borderline type)
What are some histrionic personality disorder symptoms?
- Shallow and liabile affect
- Self dramatisation
- Suggestibility
- Seeks centre of attention
- Inappropriate seductiveness
- Very concerned with physical attractiveness.
What are some dissocial personality disorder symptoms?
- Blames others
- Callous unconcern
- Gross and persistent irresponsibility
- Unable to endure relationships
- No guilt
- Low violence threshold
What are some emotionally unstable (impulsive type) personality disorder symptoms?
- Unstable mood
- Impulsivity
- Conflict
What are some emotionally unstable (borderline type) personality disorder symptoms?
- Emptiness
- Effort to avoid abandonment
- Unstable intense relationships
- Uncertain self image
- Self harm
What are the subtypes of fearful/anxious personality disorder traits?
Anakastic
Dependent
Anxious
What are some anakastic personality disorder symptoms?
- Preoccupied with detail
- Perfectionist
- Doubtful
- Rigid/stubborn
What are some dependent personality disorder symptoms?
- Allows others to make important decisions
- Unwilling to make reasonable demands on others
- Helpless when alone
- Subordination of own needs to others
- Fear of abandonment
What are some anxious personality disorder symptoms?
- Feeling of tension and apprehension
- Preoccupied when criticised
- Feeling of socially inept
- Restrict lifestyle due to need of security
What are some investigations for personality disorder?
?MRI if concern over organic causes of personality change (frontal tumor, SDH)
Careful and thorough assessment
Psychometric assessment i.e. Millon Clinical Multiaxial Inventory MCMI.
What is the management for personality disorder?
Treat comorbid disorders.
?Low dose antipsychotics. Antidepressant in emotionally unstable personality disorder. Carbemazapine to manage aggression in odd/eccentric cluster.
Psychotherapy (DBT)
What are the complications associated with personality disorder? What is the prognosis of personality disorder?
High morbidity and mortality.
- Paranoid: Poor prognosis, difficulties pervasice
- Schizoid: Poor prognosis, difficulties pervasive
- Histrionic: May improve with age, drug abuse linked.
- Dissocial: Variable, may improve with age
- Emotionally unstable: May improve with age. Abuse of substances, depressive risk and suicide risk.
- Anakastic: May go on to develop OCD, may do well at jobs requiring obsessional behavior.
- Dependent: Good outcome with treatment. Loss of person they are dependent on has poor prognosis.
- Anxious: May develop social phobia.
