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Personality disorders (Pathophysiology (Controversial (Medicalising,…
Personality
disorders
Definition
Psychological disorder of
long-lasting, rigid pattern of
thought, affect and behaviour
Epidemiology
Commoner in young
Pathophysiology
Spectrum of traits with overlap
Abnormal personality if extreme and maladaptive,
causing functional or social dysfunction
Personality encompasses lasting traits
Controversial
Medicalising
Final resort
Blame
No organic cause
Types
Cluster B
(dramatic/emotional)
Antisocial
Aggressive, frustrated, callous, impulsive, irresponsible,
lack of guilt, can't maintain relationships, criminal
Emotionally unstable
(A) Borderline:
empty, unclear identity, intense/unstable rels,
liable affect, self-harm, impulsive, pseudohallucinations
(B) Impulsive:
easily angered, inability to plan, labile mood/behaviour
Histrionic
Dramatic, self centred, shallow, labile mood, seeks attention/excitement, manipulative, seductive
Narcissistic
Self important, lacks empathy, takes advantage,
grandiose, needs admiration
Cluster C
anxious/avoidant)
Anakastic/obsessive-compulsive
Worried/doubtful, orderliness/control, perfectionist, sensitive to criticism, rigid, indecisive, judgemental, pedantic
Anxious
Anxious, tense, self-conscious, insecure, fear of negative evaluation, timid, desires to be liked
Dependent
Clingy, submissive, need for care, helpless, hopeless, incompetent
Cluster A
(odd/eccentric)
Schizoid
Emotionally cold, lack of interest, fantasy, introspective
Paranoid
Suspicious, conspiracy, distrustful, grudges
Diagnosis
Examination
General, MSE
Investigations
Often nil
History
Prev admissions
Self-harm/suicidal ideation
Management
Conservative
Individual goals
Crisis management
Treat comorbidities
Psychological
Dialectical behavioural therapy
Therapeutic communities
Mentalisation
Prognosis
Generally poor
Morbidity and mortality