Personality Disorders

Question 1

Personality disorder - pathology

Answer 1

Condition that affects how you think, feel, behave or relate to other people

Question 2

Personality disorder - aetiology

Answer 2

• Environmental
  
  • Attachment difficulties
  • Family dysfunction
• Neurological
  
  • Electroencephalogram (EEG) abnormalities in some groups
• Genetic
  
  • Especially schizotypal and antisocial

Question 3

Personality disorder - epidemiology

(prevalence)

Answer 3

• 10% prevalence community
• 20% prevalence GP
• 30% prevalence psychiatric outpatients
• 40% prevalence psychiatric in patients

Question 4

Personality disorder - classification

Answer 4

• Borderline personality disorder
• Antisocial personality disorder
• Schizoid
• Dissocial (antisocial)
• Emotionally unstable (impulsive/borderlines)
• Histrionic
• Anakastic
• Anxious
• Dependent

Question 5

Borderline personality disorder - aetiology

Answer 5

• When relationships are strained, real distress, frantic efforts to avoid abandonment

Question 6

Borderline personality disorder - symptoms

Answer 6

• Symptoms – self-injury to regulate feelings, transient stress-related mood and psychotic like disturbances

Question 7

Borderline personality disorder - treatment

Answer 7

• Treatment – mentalisation-based treatment (improve capacity to keep reflective function at times of distress), or dialectical behaviour therapy (improve skills for distress tolerance)

Question 8

Antisocial personality disorder - presentation

Answer 8

• Tendency towards offending behaviour, difficulties with impulse control and anger, often difficulty emphasising for others

Question 9

Personality disorder - general presentation

Answer 9

• General
  
  • Severe disturbance in behaviour/behaviour
  • Usually involving several areas of personality
  • Associated with considerable personal/social distress

Question 10

What age must somone be to have personality disorder diagnosed?

Answer 10

Diagnosis inappropriate before 16/17

Question 11

Personality disorder - management

Answer 11

• Thorough assessment and biopsychotherapy approach
• MDT approach
• Psychotherapy
  
  • Prescribing in short-term indicated for co-morbidity and crises
  • Discouraged prescribing in medium to long term

Question 12

Personality disorder - prognosis

Answer 12

• High morbidity and mortality
• High rate co-morbidity such as with psychosis or affective disorder
• High risk of suicide (6x standard)