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Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

What is the ICD-10 definition of personality disorder?

A

A severe disturbance in the characterological condition and behavioural tendencies of the individual, usually involving several areas of the personality and nearly always associated and considerable personal and social disruption.

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2
Q

What are the categories of personality disorders in ICD-10?

A 
•	Paranoid personality disorder
•	Schizoid Personality disorder
•	Dissocial Personality disorder
•	Emotionally unstable personality disorder- Borderline, Impulsive
•	Histrionic personality disorder
•	Anankastic personality disorder
•	Anxious personality disorder
•	Other specific personality disorders - 
o	Eccentric
o	Immature
o	Narcissistic
o	Passive-aggressive
o	Psychoneurotic
o	Dependent
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3
Q

What percentage of the UK population have a personality disorder?

A

4-11%

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4
Q

What percentage of the prison population have a personality disorder?

A

60-70%

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5
Q

What is the gender bias for each of the types of personality disorder?

A
  • Paranoid  male
  • Schizoid  male
  • Dissocial  male
  • Emotionally unstable  female
  • Histrionic  male
  • Narcissistic  male
  • Anankastic  Male
  • Dependent  female
  • Anxious  equal
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6
Q

What factors in childhood are likely to be linked to personality disorder?

A
  • Sexual abuse
  • Physical abuse
  • Emotional abuse
  • Neglect
  • Being bullied
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7
Q

What emotional behavioural factors may be linked to personality disorders?

A
  • Truanting
  • Bullying others
  • Being expelled/suspended
  • Running away from home
  • Deliberate self-harm
  • Prolonged periods of misery/low mood
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8
Q

What is the presentation of paranoid personality disorder?

A
  • Suspicious,
  • Preoccupied with conspiratorial explanations
  • Distrust others, even friends and associates
  • Hold grudges
  • Information confided to others will be used maliciously
  • Spouse/partner is unfaithful (Othello syndrome = Pathological jealousy)
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9
Q

What is the presentation of schizoid personality disorder?

A
  • Withdrawal from affection, social and other contacts
  • Isolated
  • Limited capacity to experience pleasure
  • Limited capacity to express feelings
  • Rich fantasy world
  • Excessive introspection
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10
Q

What is the dissocial personality disorder presentation?

A
  • Aggressive +low threshold for violence
  • Easily frustrated
  • Callous lack of concern for others
  • Irresponsible and impulsive
  • Unable to maintain relationships
  • Criminal activity
  • Lack of guilt
  • Inability to modify behaviour in response to adverse events e.g. punishment
  • Tendency to blame others
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11
Q

What is the presentation of those with borderline emotionally unstable personality disorder?

A
  • Feeling of emptiness
  • Unclear identity
  • Intense and unstable relationships
  • Unpredictable affect
  • Threats or acts of self-harm
  • Impulsivity
  • Pseudo hallucinations
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12
Q

What is the presentation of those with impulsive emotionally unstable personality disorder?

A
  • Inability to control anger
  • Inability to plan
  • Unpredictable affect and behaviour
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13
Q

What is the presentation of those with histrionic personality disorder?

A 
Shallow and labile affectivity and theatricality 
•	Lack of consideration for others
•	Tendency for egocentricity
•	Often crave excitement and attention
•	Over-dramatize
•	Manipulative
•	seductive
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14
Q

What is the presentation of those with anankastic personality disorder?

A
  • Feelings of doubt and worry
  • Excessive conscientiousness
  • Compulsion to check and a preoccupation with details
  • Tends to be stubborn, cautious and rigid
  • Unwelcome thoughts may intrude
  • Impulses that do not attain severity of OCD
  • Perfectionism
  • Sensitive to criticism
  • Judgemental
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15
Q

What is the presentation of those with narcissistic personality disorder?

A
  • High self-importance
  • Lacks empathy
  • Takes advantage
  • Grandiose
  • Needs admiration
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16
Q

What is the presentation of anxious (avoidant) personality disorder?

A
  • Feelings of tension and apprehension
  • Insecure and feel inferior
  • Yearn to be liked and accepted
  • Sensitive to rejection
  • Tendency to exaggerate potential dangers and risks, leading to avoidance of everyday activities
17
Q

What is the presentation of those with dependent personality disorder?

A
  • Reliance on others take decisions
  • Fear of abandonment
  • Excessive reliance on authority figures
  • Difficult acting independently
  • Feels helpless when not in a relationship
  • Feels hopeless and incompetent
18
Q

What are possible physical signs seen in those with personality disorder?

A
  • Signs of self-harm especially in those with emotionally unstable personality disorder
  • Substance misuse if common and so may present with physical stigmata or alcoholism or drug abuse
19
Q

In order to diagnose a personality disorder, what criteria must it meet?

A
  1. Markedly disharmonious attitudes and behavioural, involving usually several areas of functioning e.g. affectivity, arousal, impulse control, relationships
  2. Prevailing, chronic, abnormal behaviour patterns, not limited to discrete episodes, which are pervasive and clearly maladaptive
  3. Present in a broad range of personal and social situations
  4. Manifestations appear <18 years old and continue into adulthood
  5. There is a considerable amount of personal distress caused by these patterns of behaviour (although may only become apparent later in the course of the disorder)
  6. Associated with significant problems in occupational and social performance
20
Q

What general management would be done for those with personality disorder?

A
  • Treat individual
  • Reflect their goals
  • Help manage crises
  • Treat comorbid conditions
  • Consider patient/professional relationship
21
Q

What talking therapies may be offered for patients with personality disorder?

A
  • Dialectical behavioural therapy (DBT)  combines individual and group therapy using mindfulness, CBT and Eastern philosophy
  • Therapeutic communities
  • CBT
  • Interpersonal therapy
  • Group psychotherapy
  • Mentilization
  • Psychodynamic psychotherapy
22
Q

What is the prognosis of personality disorders?

A

Generally poor. People with diagnosis of mental health have higher rates of morbidity and mortality and lowered quality of life

23
Q

How does the prevalence of personality disorders change with age?

A

Decreases

Psychiatry (40 decks)

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