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PD

The document discusses personality disorders, defining them as persistent and stable deviations in emotional, cognitive, and behavioral traits that cause distress or dysfunction. It outlines classifications from ICD and DSM, epidemiology, etiology, and management guidelines, emphasizing the importance of tailored treatment approaches. The document also highlights the challenges in diagnosis and the comorbidity of personality disorders with other psychiatric conditions.

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Amàr Aqmar
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61 views14 pages

PD

The document discusses personality disorders, defining them as persistent and stable deviations in emotional, cognitive, and behavioral traits that cause distress or dysfunction. It outlines classifications from ICD and DSM, epidemiology, etiology, and management guidelines, emphasizing the importance of tailored treatment approaches. The document also highlights the challenges in diagnosis and the comorbidity of personality disorders with other psychiatric conditions.

Uploaded by

Amàr Aqmar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

PERSONALITY

DISORDERS
Terms & Concepts

Persona= mask worn by theatre actors


Humors & Doshas

Personality is the Combination of Emotional ,


Cognitive & Behavioural traits that
charcterise each one of us
Persistent & (relatively) stable

Egs : an aggressive man, a nervous woman…


Stress can  accentuation/decompensation
Personality Disorder Definitions
Some Examples

Concerned about themselves or (more


commonly) others are concerned about them

A young woman who take impulsive drug


overdoses everytime a boyfriend leaves her
A trainee doctor who cannot get along with
his team & repeatedly appears to ignore
feedback regarding his overconfidence
A meticulous & perfectionistic man who ha
always struggled to complete any task to his
satisfaction
CLASSIFICATIONS

 ICD 10 - 10 types

 DSM 5- 3 Clusters A,B & C..


 Clusters A- eccentric, B-dramatic , C-anxious
 Multiaxial system : Axis 1 & Axis 2

 ICD 11 -mild/moderate/severe PD & P “Difficulty”


5 trait domains = Negative affectivity, Detachment,
Dissociality, Disinhibition, Anankastia

 Categorical vs Dimensional approaches


Diagnosis : General

Marked deviation of one/more aspects of


personality

Distress/Dysfn for pts/those he interacts with


Dysfn occurs across range of situations
 C’stics pervasive,stable & recognizable since
late adolescence

Then subtyped into specific PD/Mixed


Epidemiology

2-15% prevalence UK
UK Prisons M/F ~ 50/30 %
Psychiatric patients ~ 50 %
Substance dependence & eating disorders ~
70 %

Issues of Case definition & thresholds
Etiology

Little known as is the determinants of normal


P

Borderline & Dissocial/Psychopathic most


studied
Childhood patterns : CDASPD, BITUAAPD ?
Abuse, adversities, CSA & BPD
Personality Traits ~ 35-50 % heritable, N &
E,
XXY overstated link to aggression
Personality drs & Psychiatric drs

Predispose : Anxious Avoidant PD Anxiety


drs
DD : Paranoid PD vs Delusional dr
Dimensional continuum : Schizotypal ,
Cyclothymia
Comorbidity : Borderline + Bipolar
Pathoplastic ; Anankastic traits ^ by
Depression
Some Personality Miscellanea

Authoritarian Personality ( Adorno 1950 )


Right Wing Authoritarianism ( Altermeyer
1981)
Dark Personality traits-
Machiavellism,psychopathy..
Passive Aggressive Personality
Actors , Histrionics & Narcissism
Hysteria & the wandering uterus
Narcissistic populist leaders
Donald Trump & the Goldwater rules
Management Basic Guidelines

Can be difficult..
Help pt avoid problem situations like
intox/confrontations
Find a lifestyle that suits their strengths &
minimizes their difficulties egs..
Be consistent in managing crises. IP rarely
helpful
Careful DD from mood drs & psychosis, may
overlap
Written care plan..Avoid “splitting”
Clear boundaries about unacc behrs & nature
of care
Management Guidelines Cont’d

Treat any coexisting psychiatric disorder


Treat any coexisting substance use disorder
Psychothepeutic assessment
Psychotherapy : DBT, IPPST, CAT..
Medications : very limited role, none licensed
Treating troublesome symptom
Patience, patience, patience…

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