Personality Disorders or Disorder

Introduction

Personality disorders or disorder is a type of mental illness characterised by

long term, rigid patterns of thinking and behaviour that is abnormal. Such
abnormal, maladaptive behaviour creates problems in daily living,
relationships and ability to function efficiently at work, school or social
situations. Earlier they were called as character disorders.

The character of an individual is shown through his or her personality such as

by the way he/she thinks, feels, and behaves. When the behaviour is
inflexible, maladaptive and antisocial causing significant distress for the
individual and for others then such an individual is said to have a personality
disorder.

Personality disorders are common conditions affecting 10% and 15% of the
general population. They often begin as problems in personal development
and character in childhood and peak during adolescence. Hence they are
usually diagnosed during adolescence or early adulthood. However they often
go unrecognized because those afflicted do not realise that they have a
problem as their way of thinking and behaving seems natural to them. They
hence do not seek help or treatment.

There are many specific types of personality disorders. They may vary from
mild to severe. Based on their own set of behaviours and symptoms they are
grouped into three different categories or clusters.

The different clusters include Cluster A: characterized by odd, eccentric

thinking or behaviour. It includes paranoid personality disorder 9 the
individual cannot be trusted and is suspicious), schizoid personality disorder
(the individual has an indifferent attitude and is an introvert) and schizotypal
personality disorder (the individual dwells on delusions).

Cluster B: characterized by dramatic, overly emotional or erratic thinking or

behaviour. It includes antisocial personality disorder (in this the individual
gains pleasure in bullying others), borderline personality disorder (the
individual has the tendency to harm himself and has an unstable relationship
with others), histrionic personality disorder (the individual wants to be the
centre of attention) and narcissistic personality disorder (these individuals
think very high of themselves).

Cluster C: characterized by anxious, fearful thinking or behaviour. It includes

avoidant personality disorder (these individuals are extremely shy and
sensitive), dependent personality disorder (these individuals are always
dependent on others) and obsessive-compulsive personality disorder (.

Signs and Symptoms

The general signs and symptoms of individuals with a personality disorder

include frequent mood swings, stormy relationships, social isolation, angry
outbursts, suspicion and mistrust of others, difficulty in making friends, need
for instant gratification, poor impulse control or impulsive behaviour such as
excessive spending, binge eating and risky sex, alcohol or substance abuse.

Diagnosis

The doctor makes a diagnosis based on the individual’s history or the

information given by family, friends or peers, signs and symptoms, physical
examination, psychological evaluation/assessment, laboratory tests such as a
complete blood count and thyroid function test.

Treatment
Treatment may vary according to the type of personality disorder but the
general management measures include psychotherapy which includes
cognitive and behavioural therapy (CBT). It is type of talk therapy in which
the affected individual, group or family are counselled by the therapist to
recognize, relax, and cope with their thoughts, feelings and behaviour.
Medications are usually prescribed to relieve some of the symptoms of
personality disorders, including problems with anxiety and perceptions such
as anti-anxiety medicines, antidepressants and antipsychotics. Sometimes
hospitalization may be effective. Participation in self-help groups may also be
helpful.

Complications

Certain complications of personality disorders include distress due to

difficulties with proper functioning in social, personal, professional, vocational
and other important realms of life. Development of other mental health
problems such as depression, anxiety, panic disorders, eating disorders,
deliberate self-harm and substance misuse.

Outcome

The outcome is good with proper medical and psychological help.

Prevention

There is no known way to prevent them but early identification and

intervention may help.

More Information:

Blais, M.A., Smallwood, P., James E. Groves, J.E. and Rivas-Vazquez, R.A.
(2008), Personality and Personality Disorders, in: Stern, T.A.,
 Rosenbaum, J.F., Fava, M., Biederman, J., and Rauch, S.L. (eds),
Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st
ed, Mosby, Philadelphia.

Centre for Addiction and Mental Health (2012), Personality Disorders,

[Online], Available:
http://www.camh.ca/en/hospital/health_information/a_z_mental_healt
h_and_addiction_information/Personality-Disorder/Pages/default.aspx,
[Accessed: 2013, May 16].

Feinstein, R.E. and Connelly, J.V. (2007), Personality Disorders, in: Rakel,
R.E. (ed), Textbook of Family Medicine, 7th ed, Saunders, Philadelphia.

Giese, A.A. (2001), Personality and Personality Disorders, in; Jacobson, J.L.
and Jacobson, A.M. (eds), Psychiatric Secrets, 2nd ed, Hanley &
Belfus, inc, Philadelphia.

Mayo Clinic (2010), Personality Disorders, [Online], Available:

http://www.mayoclinic.com/health/personality-disorders/DS00562,
[Accessed: 2013, May 15].

Medline Plus (2012), Personality Disorders, [Online], Available:

http://www.nlm.nih.gov/medlineplus/ency/article/000939.htm,
[Accessed: 2013, May 16].

Mental Health Foundation, Personality Disorders, [Online], Available:

http://www.mentalhealth.org.uk/help-information/mental-health-a-
z/P/personality-disorders/, [Accessed: 2013, May 16].

Morenz, B. (2007), Mental Health in the Wilderness, in: Auerbach, P.S. (ed),
Wilderness Medicine, 5th ed, Mosby, Philadelphia.
NHS Choices (2012), Personality disorder, [Online], Available:
http://www.nhs.uk/Conditions/Personality-
disorder/Pages/Definition.aspx, [Accessed: 2013, May 16].

Schiffer, R.B. (2007), Psychiatric Disorders in Medical Practice, in: Goldman,

L. and Ausiello, D. (eds), Cecil Medicine, 23rd ed, Saunders,
Philadelphia.

Svrakic, D.M. and Cloninger, C.R. (2005), Personality Disorders, in: Sadock,
B.J. and Sadock, V.A. (eds), Kaplan & Sadock’s Comprehensive
Textbook of Psychiatry, 8th ed, vol 2, Lippincott Williams and Wilkins,
Philadelphia.

The Merck Manual of Medical Information (2012), Personality Disorders,

[Online], Available:
http://www.merckmanuals.com/home/mental_health_disorders/perso
nality_disorders/personality_disorders.html?qt=&sc=&alt=, [Accessed:
2013, May 16].