Skip to main content Accessibility help
×
Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-01-08T05:35:34.620Z Has data issue: false hasContentIssue false

Chapter 24 - Other Personality Disorders

Published online by Cambridge University Press:  02 January 2025

Marsal Sanches
Affiliation:
McGovern Medical School, Texas
Jair C. Soares
Affiliation:
McGovern Medical School, Texas
Get access

Summary

Personality disorders play a major role in psychiatric clinical practice. Usually evident by adolescence, they arise when emotions, thoughts, impulsivity, and especially interpersonal behavior deviate markedly from the expectations of the individual’s culture. These disorders comprise a group of diverse and complex conditions that still warrant better understanding across multiple dimensions: genetic, neurobiological, pharmacological, and psychodynamic. This chapter addresses the definitions of both personality and personality disorder and outlines the two sets of diagnostic criteria: primary characteristics of personality disorder and the three main categories/clusters of personality disorder. It also discusses incidence of the specific disorders and relevant treatment modalities. Treatments plans should include psychotherapy, psychopharmacology, and psychoeducation, as well as treatment of comorbidities and crises. Psychotherapy has been the intervention of choice for most personality disorders, with pharmacological treatment usually auxiliary and focused on symptoms. Clinician skill is a key element of diagnosis and treatment. An experienced clinician should be able to differentiate between personality traits or styles and actual personality disorders, a particularly challenging task when a patient presents in crisis. Individuals with personality disorders can manifest a disturbed pattern in interpersonal relationships that can be deleterious in the therapeutic relationship if not approached with skill.

Type
Chapter
Information
Fundamentals of Clinical Psychiatry
A Practical Handbook
, pp. 239 - 246
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Skodol, A. E., Oldham, J. M., The American Psychiatric Association Publishing Textbook of Personality Disorders, 3rd ed. (American Psychiatric Publishing, 2021).CrossRefGoogle Scholar
Widiger, T. A., The Oxford Handbook of Personality Disorders (Oxford University Press, 2012).CrossRefGoogle Scholar
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR, 5th edition, text revision (American Psychiatric Association Publishing, 2022).Google Scholar
Lenzenweger, M. F., Lane, M. C., Loranger, A. W., Kessler, R. C., DSM-IV personality disorders in the national comorbidity survey replication. Biological Psychiatry, 62 (2007), 553564. https://doi.org/10.1016/j.biopsych.2006.09.019.CrossRefGoogle ScholarPubMed
Hasin, D. S., Grant, B. F., The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) waves 1 and 2: review and summary of findings. Social Psychiatry and Psychiatric Epidemiology, 50 (2015), 16091640. https://doi.org/10.1007/s00127–015-1088-0.CrossRefGoogle ScholarPubMed
Lee, R. J., Mistrustful and misunderstood: a review of paranoid personality disorder. Current Behavioral Neuroscience Reports, 4 (2017), 151165. https://doi.org/10.1007/s40473–017-0116-7.CrossRefGoogle ScholarPubMed
Blackmon, W. D., Dungeons and Dragons: the use of a fantasy game in the psychotherapeutic treatment of a young adult. American Journal of Psychotherapy, 48 (1994), 624632. https://doi.org/10.1176/appi.psychotherapy.1994.48.4.624.CrossRefGoogle ScholarPubMed
Teraishi, T., Hori, H., Sasayama, D., Matsuo, J., Ogawa, S., Ishida, I., Nagashima, A., Kinoshita, Y., Ota, M., Hattori, K., Kunugi, H., Relationship between lifetime suicide attempts and schizotypal traits in patients with schizophrenia. PLoS ONE, 9 (2014), e107739. https://doi.org/10.1371/journal.pone.0107739.CrossRefGoogle ScholarPubMed
Boland, R., Verdiun, M., Ruiz, P., Kaplan and Sadock’s Synopsis of Psychiatry, 12th ed. (Wolters Kluwer Health, 2021).Google Scholar
Jakobsen, K. D., Skyum, E., Hashemi, N., Schjerning, O., Fink-Jensen, A., Nielsen, J., Antipsychotic treatment of schizotypy and schizotypal personality disorder: a systematic review. Journal of Psychopharmacology (Oxford, England), 31 (2017), 397405. https://doi.org/10.1177/0269881117695879.CrossRefGoogle ScholarPubMed
Bender, D. S., The therapeutic alliance in the treatment of personality disorders. Journal of Psychiatric Practice, 11 (2005), 7387. https://doi.org/10.1097/00131746-200503000-00002.CrossRefGoogle ScholarPubMed
Dhawan, N., Kunik, M. E., Oldham, J., Coverdale, J., Prevalence and treatment of narcissistic personality disorder in the community: a systematic review. Comprehensive Psychiatry, 51 (2010), 333339. https://doi.org/10.1016/j.comppsych.2009.09.003.CrossRefGoogle ScholarPubMed
Stinson, F. S., Dawson, D. A., Grant, B. F., Goldstein, R. B., Chou, S. P., Boji, H., Smith, S. M., Ruan, W. J., Pulay, A. J., Saha, T. D., Pickering, R. P., Prevalence, correlates, disability, and comorbidity of DSM-iv narcissistic personality disorder: results from the wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69 (2008), 10331045. https://doi.org/10.4088/JCP.v69n0701.CrossRefGoogle ScholarPubMed
Vater, A., Ritter, K., Strunz, S., Ronningstam, E. F., Renneberg, B., Roepke, S., Stability of narcissistic personality disorder: tracking categorical and dimensional rating systems over a two-year period. Personality Disorders, 5 (2014), 305313. https://doi.org/10.1037/per0000058.CrossRefGoogle Scholar
Young, S., Rhodes, P., Touyz, S., Hay, P., The relationship between obsessive-compulsive personality disorder traits, obsessive-compulsive disorder and excessive exercise in patients with anorexia nervosa: a systematic review. Journal of Eating Disorders, 1 (2013), 16. https://doi.org/10.1186/2050-2974-1-16.CrossRefGoogle ScholarPubMed
Diedrich, A., Voderholzer, U., Obsessive-compulsive personality disorder: a current review. Current Psychiatry Reports, 17 (2015), 2. https://doi.org/10.1007/s11920–014-0547-8.CrossRefGoogle ScholarPubMed
Weinbrecht, A., Schulze, L., Boettcher, J., Renneberg, B., Avoidant personality disorder: a current review. Current Psychiatry Reports, 18 (2016), 29. https://doi.org/10.1007/s11920–016-0665-6.CrossRefGoogle ScholarPubMed
Herpertz, S. C., Zanarini, M., Schulz, C. S., Siever, L., Lieb, K., Möller, H.-J.. D, WFSBP Task Force on Personality, World Federation of Societies of Biological Psychiatry (WFSBP), Guidelines for biological treatment of personality disorders. The World Journal of Biological Psychiatry, 8 (2007), 212244. https://doi.org/10.1080/15622970701685224.CrossRefGoogle ScholarPubMed
Ingenhoven, T., Lafay, P., Rinne, T., Passchier, J., Duivenvoorden, H., Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials. Journal of Clinical Psychiatry, 71 (2010), 1425. https://doi.org/10.4088/JCP.08r04526gre.CrossRefGoogle ScholarPubMed
Karaszewska, D. M., Ingenhoven, T., Mocking, R. J. T., Marine omega-3 fatty acid supplementation for borderline personality disorder: a meta-analysis. Journal of Clinical Psychiatry, 82 (2021). https://doi.org/10.4088/JCP.20r13613.Google ScholarPubMed
Lingiardi, V., Filippucci, L., Baiocco, R., Therapeutic alliance evaluation in personality disorders psychotherapy. Psychotherapy Research, 15 (2005), 4553. https://doi.org/10.1080/10503300512331327047.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×