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Psychiatry > Personality disorder > Flashcards

Personality disorder Flashcards

1
Q

What is the aetiology of personality disorder?

A

Genetics
Childhood temperament (attachment problems, conduct disorders)
Childhood experience (neglect, trauma, abuse)
Neurochemical imbalance

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2
Q

What is the epidemiology of personality disorder?

A 
Epidemiological community survey 10%	
Primary care- 20%	C
Psychiatric outpatients- 30%	B
Psychiatric inpatients- 40%	B
Prison- 50%	B
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3
Q

What are common comorbid conditions with personality disorder?

A

Anxiety Disorder (especially Cluster C personality disorder)
Depression (particularly difficult to spot in emotionally unstable patients where it can easily be mistaken for emotional lability or ignored because mood problems are assumed to be a consequence of emotional lability. Good history taking is essential in such cases)
PTSD
Substance Misuse & alcoholism
Adjustment Disorder/ Stress Reaction

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4
Q

What is the classification for personality disorder?

A 
Cluster A: odd and eccentric
Schizoid 
Paranoid 
Schizotypal 
Cluster B: dramatic and emotional
Antisocial
Histrionic
Borderline
Narcissistic
Cluster C: anxious and fearful
Obsessive compulsive
Anxious 
Dependent
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5
Q

What is the ICD-10 classification for types of personality?

A 
Paranoid
Schizoid 
Schizotypal 
Dissocial 
Borderline 
Narcissistic (DSM)
Anakastic 
Anxious (avoidant)
Dependent
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6
Q

What is paranoid personality disorder? (SUSPECT)

A 
Sensitive
Unforgiving
Suspicious
Possessive and jealous of partners
Excessive self-importance
Conspiracy theories
Tenacious sense of rights
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7
Q

What is schizoid personality disorder? (ALL ALONE)

A 
Anhedonic
Limited emotional range
Little sexual interest
Apparent indifference to praise or criticism
Lack of close relationships
One-player activities
Normal social conventions ignored
Exessive fantasy world
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8
Q

What is is dissocial personality disorder? (FIGHTS)

A 
Forms but cannot maintain relationships
Irresponsible
Guiltless
Heartless
Temper easily lost
Someone else’s fault
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9
Q

What is emotionally unstable (borderline) personality disorder? (SCARS)

A 
Self-image unclear
Chronic “empty” feelings
Abandonment fears
Relationships are intense and unstable
Suicide attempts and self-harm
Occasionally experience fleeting psychotic features (pseudohallucinations)
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10
Q

What is emotionally unstable (impulsive) personality disorder? (LOSE IT)

A 
Lacks impulse control
Outbursts or threats of violence
Sensitivity to being criticised or let down
Emotional instability
Inability to plan ahead
Thoughtless of consequences
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11
Q

What are common features for both types of emotionally unstable personality disorders?

A 
Affective instability
Explosive behaviours
Impulsive
Outbursts of anger
Unable to plan or consider consequences
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12
Q

What is histrionic personality disorder? (ACTORS)

A 
Attention Seeking
Concerned with own appearance
Theatrical
Open to suggestion
Racy and seductive
Shallow affect
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13
Q

What is anankastic personality disorder? (DETAILED)

A 
Doubtful
Excessive detail
Tasks not completed
Adheres to rules
Inflexible
Likes own way
Excludes pleasure and relationships
Dominated by intrusive thoughts
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14
Q

What is anxious/avoidant personality? (AFRAID)

A 
Avoids social contact
Fears rejection / criticism
Restricted lifestyle
Apprehensive
Inferiority
Doesn't get involved unless sure of acceptance
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15
Q

What is dependent personality disorder? (SUFFER)

A 
Subordinate
Undemanding
Feels helpless when alone
Fears abandonment
Encourages others to take decisions
Reassurance needed
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16
Q

What is the short term management for those with personality disorders?

A

Risk assessment- self harm, suicide, substance abuse

Consider comorbidity

17
Q

What is the long term management for those with personality disorders?

A

Cognitive Behavioural Therapy (CBT)
Dialectical Behavioural Therapy (DBT)
Cognitive Analytical Therapy (CAT)
Therapeutic communities

18
Q

Which medications are used for personality disorders?

A

NICE do not recommend pharmacological treatment for either emotionally unstable or dissocial personality disorder.
May be a need to treat complicating comorbid problems (psychosis, ADHD)
Antipsychotics: for transient psychotic experiences, reduction of impulsivity and agitation
Antidepressants for comorbid illness such as anxiety and depression
Mood stabilisers for mood instability

19
Q

What is the prognosis for personality disorder?

A

Linked with a higher rate of suicide, especially cluster B disorders
cluster B disorders seem to be less common with increasing age

20
Q

What is splitting?

A

Defence mechanism seen in borderline personality disorder

Patient is unable to reconcile both good and bad traits in a given person, assess people as either all good ir all bad

Psychiatry (21 decks)

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