Personality Disorders

In this lecture, we will talk about the presentation to a range of personality disorders. 

A person with a personality disorder will
think differently, 
Feel differently
behave differently 
or relates to others very differently from the average person.

The DSM-V states there are several different types of personality disorder, split into 3 clusters: 
Cluster A: Peculiar thought processes, inappropriate affect – remember them as WEIRD
Cluster B: Mood lability, dissociative symptoms, preoccupation with rejection remember them as WILD
Cluster C: Anxiety, preoccupation with criticism or rigidity remember them as WORRIED

Causes
It's not clear exactly what causes personality disorders, but they're thought to result from a combination of the genes a person inherits and early environmental influences – for example, a distressing childhood experience (such as abuse or neglect).

Prevalence:
All are relatively common.
More males have antisocial and narcissistic PDs
More females have borderline and histrionic PDs. 

Onset:
Usually not diagnosed until late adolescence or early adulthood 

Course. 
Usually very chronic over decades without treatment. 
Symptoms of paranoid, schizoid, and narcissistic PD often worsen with age; 
symptoms of antisocial and borderline PD often ameliorate. 

Key Symptoms. 
A long pattern of difficult interpersonal relationships, problems adapting to stress, failure to achieve goals, chronic unhappiness, low self-esteem 

Personality disorders are usually associated with mood disorders.

Treatment: 
Psychotherapy is the mainstay of treatment. Intensive and long-term psychodynamic and cognitive therapy are treatments of choice for most PDs. 
Use of mood stabilizers and antidepressants is sometimes useful for Cluster B PDs. 

Differential Diagnosis: 
Major rule-outs are mood disorders, personality change due to a general medical condition, and adjustment disorders.