Hypermethylation of which gene is most likely to be associated with ASPD?
MAO-A promoter gene
Which PD is a predisposing factor for paraphrenia?
Paranoid PD
What is paraphrenia?
organised system of paranoid delusions with or without hallucinations
Diagnostic criteria for narcissisic PD
- grandiose sense of self-importance
- fantasies of unlimited success, power, brilliance, beauty, or ideal love
- beliefs that they are special and can only be understood by other special people
- requires excessive admiration
- sense of entitlement
- interpersonally exploitative
- lacks empathy
- often envious of others or believes others are envous of them
Diagnostic criteria for histrionic PD
- self dramatisation
- theatricality
- exaggerated expression of emotions
- suggestibility
- easily influenced by others
- show and labile affect
- inappropriate seductiveness
- overconcern with physical attractiveness
Diagnostic criteria for EUPD
- emotional instability
- self-image, aims and internal preferences are often unclear
- intense unstbale relationships casue repeated emotional crises
- efforts to avoid abandonment such as suicide threats or DSH
Which treatment options are available for paranoid PD?
indicated - supportive therapy and problem-solving therpay
CBT is helpful and a course of an antidepressant may be useful
Prevalence of EUPD in the UK?
7 in 1000
Prevalence of PD in the UK?
1 in 20
SMR in ASPD compared to general population?
8-9
Increased sensitivity to criticisms and setbacks
Paranoid PD
Fear of abandonment and rely on others
EUPD
Inability to make decisions
Dependent PD
Which symptom of EUPD improves have the natural course of life?
Impulsivity
Prevalence of anankastic PD in the UK?
19 in 1000
Prevalence of histrionic PD in the UK?
12 in 1000
Prevalence of paranoid PD in the UK?
7 in 1000 (same as EUPD)
Prevalence of schizoid PD in the UK?
8 in 1000
Prevalence of avoidant UPD in the UK?
8 in 1000
Prevalence of narcissistic PD in the UK?
8 in 1000
Diagnostic criteria for Dissocial PD
- Callous unconcern for the feelings of others;
- Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations;
- Incapacity to maintain enduring relationships, though having no difficulty in establishing them;
- Very low tolerance to frustration and a low threshold for discharge of aggression, including violence;
- Incapacity to experience guilt or to profit from experience, particularly punishment;
- Markedly prone to blame others or to offer plausible rationalizations for the behaviour that has brought the person into conflict with society.
According to DSM before which age must be evidence of dissocial traits?
15
Criteria for dependent PD
- Difficulty making everyday decisions without excessive reassurance from others
- Need for others to assume responsibility for major areas of their life
- Difficulty in expressing disagreement with others due to fears of losing support
- Lack of initiative
- Unrealistic fears of being left to care for themselves
- Urgent search for another relationship as a source of care and support when a close relationship ends
- Extensive efforts to obtain support from others
- Unrealistic feelings that they cannot care for themselves
Criteria for anakastic PD
-Feelings of excessive doubt and caution
-Preoccupation with details, rules, lists, order, organization or schedule
-Perfectionism that interferes with task completion
-Excessive conscientiousness, scrupulousness, and undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships
-Excessive pedantry and adherence to social conventions
-Rigidity and stubbornness
-Unreasonable insistence by the patient that others submit to exactly his or her way of doing things, or unreasonable reluctance to allow others to do things
Intrusion of insistent and unwelcome thoughts or impulses
