Personality Disorders Overview

Overview of Personality Disorders

• Prevalence ranges from 7-12%, with variations by gender; individuals often meet criteria for multiple disorders.
• Personality traits are persistent patterns of perception, relation, and thought toward oneself and the environment.
• Ego-syntonic refers to behaviors and thoughts aligned with the self, while ego-dystonic indicates distressing and inconsistent thoughts and feelings.
• Treatment is challenging due to lack of insight; psychotherapy is the primary approach.

Cluster A: Eccentric Personality Disorders

• Characteristics include being peculiar, withdrawn, and having a familial link to psychotic disorders like schizophrenia.
• Types include Paranoid, Schizoid, and Schizotypal Personality Disorders.

Paranoid Personality Disorder (PPD)

• Prevalence: 1-4%, more common in males.
• Key symptoms: pervasive distrust, suspicion of others, and interpretation of motives as malevolent.
• Course: chronic, with low desire for relationships; often blames others.
• Treatment: psychotherapy, avoidance of group therapy, and antipsychotics for transient psychosis.

Schizoid Personality Disorder

• Prevalence: 3-5%, more common in males.
• Key symptoms: voluntary social withdrawal, restricted emotional range, and preference for solitary activities.
• Course: chronic with lifelong withdrawal; viewed as eccentric.
• Treatment: psychotherapy, antidepressants for comorbid depression.

Schizotypal Personality Disorder

• Prevalence: 4%, gender distribution not specified.
• Key symptoms: social deficits, odd beliefs, and unusual perceptual experiences.
• Course: chronic with potential development of schizophrenia.
• Treatment: psychotherapy, low-dose second-generation antipsychotics for cognitive perceptual disturbances.

Cluster B: Dramatic Personality Disorders

• Patients exhibit erratic behavior and have familial associations with mood disorders and substance use.
• Types include Antisocial, Borderline (BPD), Histrionic (HPD), and Narcissistic Personality Disorders.

Antisocial Personality Disorder

• Prevalence: 1-4%, more common in males.
• Key symptoms: disregard for others’ rights, deceitful behavior, and history of conduct disorder.
• Treatment: psychotherapy, pharmacology for comorbid anxiety or aggression.

Borderline Personality Disorder (BPD)

• Prevalence: 6%, the most common personality disorder, more common in females.
• Key symptoms: impulsivity, unstable relationships, and fear of abandonment.
• Course: variable with potential for stability in middle age; high risk of suicide.
• Treatment: dialectical behavior therapy (DBT) as first-line; pharmacological support for mood stabilization.

Histrionic Personality Disorder (HPD)

• Prevalence: more common in females, specific data not stated.
• Key symptoms: emotionality, attention-seeking behavior, and need for admiration.
• Treatment: psychotherapy, with pharmacological support for anxiety or depressive symptoms.

Narcissistic Personality Disorder (NPD)

• Prevalence: more common in males, specific data not stated.
• Key symptoms: grandiosity, need for admiration, and lack of empathy.
• Treatment: psychotherapy and pharmacological support for associated symptoms.

Cluster C: Anxious Personality Disorders

• Patients appear fearful and anxious, closely related to anxiety disorders.
• Types include Avoidant, Dependent (DPD), and Obsessive-Compulsive Personality Disorders (OCPD).

Avoidant Personality Disorder

• Prevalence: approximately 2%.
• Key symptoms: social inhibition and hypersensitivity to criticism.
• Treatment: psychotherapy focusing on self-esteem improvement.

Dependent Personality Disorder (DPD)

• Prevalence: approximately 2%, more common in females.
• Key symptoms: excessive need for care, submissive behavior, and difficulty making decisions.
• Treatment: psychotherapy to promote independence.

Obsessive-Compulsive Personality Disorder (OCPD)

• Prevalence: 2-7%, more common in males.
• Key symptoms: preoccupation with orderliness and perfectionism, often at the expense of efficiency.
• Treatment: psychotherapy focusing on flexibility and productivity improvements.