Personality Disorders

Question 1

define a paranoid personality disorder

Answer 1

a patient with an unrelenting mistrust and suspicion of others without reason

often interprets others motives as harmful or hostile

Question 2

risk factors of paranoid personality disorder

Answer 2

male sex
childhood abuse
FH of paranoid disorders
schizophrenia

Question 3

clinical features of paranoid personality disorder

Answer 3

irrational suspicion and mistrust of others
hypersensitivity to criticism
reluctance to confide
preoccupied with percieved conspiracies against self

Question 4

investigations of personality disorders

Answer 4

Minnesota multiphasic personality inventory (MMPI)

Eysenck personality inventory

Question 5

management of paranoid personality disorder

Answer 5

CBT

atypical 2nd gen antipsychotic

Question 6

give examples of atypical 2nd gen antipsychotics

Answer 6

quetiapine

olanzapine

Question 7

define schizoid personality disorder

Answer 7

a patient with an inappropriate/lack of interpersonal relationships that often avoids others

Question 8

risk factors of schizoid personality disorder

Answer 8

family history

mental health history

Question 9

clinical features of schizoid personality disorder

Answer 9

lack of interest in others
apathy
lack emotional breadth and expression
prefer solitary activities

Question 10

important additional investigation in schizoid personality disorder

Answer 10

CT head - to rule out organic causes

Question 11

management of schizoid personality disorder

Answer 11

psychodynamic and/or group therapy

medications only if co-existing mental health disorder

Question 12

define schizotypal personality disorder

Answer 12

a patient with odd behaviour and perceptual and cognitive distorsions

Question 13

clinical features of schizotypal personality disorder

Answer 13

pattern of extreme difficulties in social interaction
bizarre/magical thinking
distorted perceptions
inappropriate behaviour/speech

Question 14

investigations of schizotypal personality disorder

Answer 14

MMPI

thorough history

Question 15

management of schizotypal personality disorder

Answer 15

psychotherapy

antipsychotics (only in acute phase)

Question 16

define antisocial personality disorder (ASPD)

Answer 16

a patient with gross discrepancy between behaviour and social norms with a pervasive pattern of disregard and violation of others rights

Question 17

clinical features of ASPD

Answer 17

patterns of unlawful, exploitative, reckless and deceitful actions
lack of empathy
selfish behaviour and consistent irresponsibility
aggressive

Question 18

management of ASPD

Answer 18

mood stabilisers

antidepressants

Question 19

define borderline personality disorder

Answer 19

a patient with:

• significant instability in interpersonal relationships, self image and mood
• patterns of fluctuating mood with strong tendencies towards suicidal thinking and self-harm
• transient psychotic symptoms

Question 20

clinical features of borderline personality disorder

Answer 20

patterns of abrupt mood swings, unstable relationships and instability with self-image
tendency towards self-harm behaviour and suicidal thoughts
alternating relationship of idealisation and devaluation
lack of temper control

Question 21

investigations of BPD

Answer 21

toxicology screen
MSE
risk assessment for crisis management

Question 22

initial management of BPD

Answer 22

assess current level of risk to self/others
ask about previous episodes
coping mechanism

Question 23

define narcissistic personality disorder

Answer 23

a patient with exaggerated feelings of self-worth that often lack empathy and require constant admiration

Question 24

clinical features of narcissistic personality disorders

Answer 24

patterns of grandiosity
constant need of admiration
lack empathy 
self-entitled 
arrogant and have preoccupation with own fantasy and desires

Question 25

investigations of narcissistic personality disorder

Answer 25

bloods 
- inflammatory marker 
- U+Es 
- serum glucose 
- syphilis and HIV serology 
CT head

Question 26

management of narcissistic personality disorder

Answer 26

CBT

psychotherapy