Personality disorders Flashcards
Percentage of the population with at least one personality disorder
4.4%
Most prevalent personality disorder in psychiatric settings
EUPD - borderline type
Most prevalent personality disorder in prison settings
Antisocial PD
Prevalence of any PD in male prisoners on remand
78%
Prevalence of any PD in male sentenced prisoners
64%
Prevalence of any PD in female prisoners
50%
Prevalence of antisocial PD in male prisoners on remand
63%
Prevalence of antisocial PD in male sentenced prisoners
49%
Prevalence of antisocial PD in female prisoners
31%
Prevalence of antisocial PD in the general population
0.6%
Prevalence of antisocial PD in the general male population
1%
Prevalence of antisocial PD in the general female population
0.2%
Prevalence of EUPD in the general population
2%
Prevalence of EUPD in the psychiatry outpatient population
10%
Prevalence of EUPD in the psychiatry inpatient population
15-20%
Male:female ratio of EUPD
1:3
Most stable traits of EUPD
Depression
Anger
Loneliness/emptiness
Traits of EUPD most likely to decrease with time
Quasi-psychotic thoughts
Self harm
Help-seeking suicide attempts
Treatment regressions
Counter transference issues
PD clusters where symptoms usually increase with age
A
C
PD cluster where symptoms usually decrease with age
B
Cluster A personality disorders
Paranoid
Schizoid
Schizotypal
PD which is found in the schizophrenia umbrella in ICD 10 and 11
Schizotypal
Features of paranoid PD
Suspicious of others
Hold longstanding grudges
Believe others are not trustworthy
Emotionally detached
Feel others are deceiving or making plans against them
Features of schizoid PD
Difficulty in expressing warm emotions
Aloof or remote
Prefer to be alone
Difficulty making and maintaining relationships
Unaware of social trends
Unresponsive to praise or criticism
Features of schizotypal PD
Odd or eccentric
Magical thinking
Obsessions (which are not distressing)
May be members of fringe cultural groups
May believe in ESP, clairvoyance etc.
Transient psychotic features
Paranoia
Cluster B personality disorders
Antisocial
BPD/EUPD
Histrionic
Narcissistic
Features of antisocial PD
Lack of regard for others
Lack of remorse for actions which harm others
Ignore law or social norms
Make and break relationships easily
May be psychopathic
Features of BPD/EUPD
Poor self image
Unstable relationships
Impulsive behaviours
Self harm and suicidal behaviours
Quasi-psychotic symptoms
Feelings of chronic emptiness
Mood instability
Features of histrionic PD
Extreme and dramatic behaviour
Form relationships quickly
Shallow emotions
Attention seeking behaviour
Appear self centred
Sexually provocative behaviour
Features of narcissistic PD
Exaggerated sense of self importance
Self centred
Intolerant of others
Cravings for attention and admiration
Grandiose plans and ideas
Cluster C personality disorders
Avoidant
Dependent
Obsessive compulsive/anankastic
Features of avoidant PD
Fears of being judged
Discomfort in group or social settings
Socially withdrawn
Low self esteem
Fears of being rejected but craves affection
Features of dependent PD
Passive
Allows others to take responsibility for their daily life
Low self confidence
Unable to function independently
Lack of regard for own needs
Features of obsessive compulsive/anankastic PD
Perfectionist
Difficulty expressing emotions
Unable to see other points of view
Rigid attention to detail that means tasks are not completed
May be frugal with money
Unable to delegate tasks
NICE guidelines for pharmacological management of PDs
Not recommended unless for comorbid illness e.g. depression
Trait domains for personality disorders in ICD 11
Negative affect
Detachment
Dissociality
Disinhibition
Anankastia
Borderline pattern (a combination of the above)
PD cluster most often seen in psychiatric outpatient settings
Cluster C
Lifetime prevalence of obsessive compulsive personality disorder
2-3%
Medication associated with increased impulsivity in patients with borderline personality disorder
Benzodiazepines
Most common personality disorder in the general population
Anankastic/obsessive compulsive
Most common personality disorder in primary care/GP services
Anankastic/obsessive compulsive
Medication class which reduces aggressive and impulsive behaviour in patients with borderline and aggressive personality disorders
SSRIs
Medications which may improve affective dysregulation in patients with cluster B personality disorders
Lithium
Anticonvulsants
Medication class which may be beneficial in low doses for patients with borderline or schizotypal personality disorders
Antipsychotics
Psychological therapy suggested for women with EUPD and self harm
Dialectical behavioural therapy
Therapy recommended by NICE for treatment of antisocial personality disorder
Group based cognitive interventions
Most common psychiatric comorbidity seen in BPD
Depression
Cut off for psychopathy on the PCL-R
30/40
Percentage of people who meet criteria for psychopathy
<1%
Percentage of patients with EUPD who have been sexually abused
40-71%
Personality disorder which cannot be diagnosed under the age of 18 as per DSM V
Antisocial personality disorder
Psychodynamic intervention not recommended for patients with BDP
Brief psychotherapeutic interventions
