scholarly journals Principles of managing patients with personality disorder

2002 ◽  
Vol 8 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Sophie E. Davison
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Mental Disorder ◽  
Personality Disorders ◽  
Clinical Skills ◽  
Management Plan ◽  
Everyday Clinical Practice ◽  
Clinical Problems

The management of individuals with personality disorder is one of the most challenging and sometimes controversial areas of psychiatry. This paper describes the principles involved in identifying the clinical problems and formulating a management plan for patients with personality disorder in everyday clinical practice. It demonstrates that the principles of assessing and managing personality disorders and the clinical skills required are no different from those of treating any other chronic mental disorder.

Personality disorders

2020 ◽  
pp. 6520-6523
Author(s):  
Iain Jordan
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Medical Management ◽  
Management Plan ◽  
Medical Settings ◽  
Recommended Treatment ◽  
The World ◽  
Consistent Response ◽  
Term Management ◽  
Over Time

People have characteristic ways of perceiving, thinking about, and responding to the world around them that are relatively stable over time and across situations; this is referred to as their personality. A diagnosis of personality disorder is made when the personality is extreme and maladaptive and causes difficulty or distress to the person themselves or to others. People with personality disorders are often encountered in medical settings, which may be because they have self-harmed, suffered problems from drug or alcohol use, or been injured because of unwise behaviour. Personality disorders also complicate the medical management of medical conditions, for example, by non-adherence to recommended treatment. The effective short-term management of personality disorders in medical settings requires: (a) recognition of the diagnosis; (b) creation of a management plan; and (c) consistent response to the problematic behaviours adhered to by all relevant staff.

scholarly journals Boredom in Borderline Personality Disorder: A Lost Criterion Reconsidered

2020 ◽  
Vol 53 (5-6) ◽  
pp. 239-253
Author(s):  
Sara R. Masland ◽  
Tanya V. Shah ◽  
Lois W. Choi-Kain
Keyword(s):  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Diagnostic Criteria ◽  
Empirical Research ◽  
Borderline Personality ◽  
Cascade Model ◽  
Identity Disturbance ◽  
Behavioral Dysregulation

Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished data. However, it is apparent in clinical practice that boredom remains relevant to BPD. This review synthesizes empirical research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining and measuring boredom and offer an expanded conceptualization for BPD, which includes the notion of boredom reactivity, before turning to boredom’s differentiation from and overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom’s significance in BPD, briefly touching on its relevance in other personality disorders. We propose a Boredom Cascade Model that articulates how boredom and boredom reactivity interact with identity disturbance and chronic emptiness to create escalating patterns of behavioral dysregulation and make recommendations for research and treatment.

Something Doesn’t Seem Right

2021 ◽  
pp. 35-42
Author(s):  
Daniel M. Doleys ◽  
Nicholas D. Doleys
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Pain Management ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Residential Placement ◽  
Controlled Substances ◽  
Female Patients

This case depicts a situation wherein the facts do not seem to fit. In a hurried and busy clinical practice, one is glad to encounter what seems to be a pleasant patient. Patients with personality disorders, especially those with a borderline personality disorder (BPD), can be very deceptive. Their overall manner is often very congenial, until their expectations or requests are not met. Their presentation may be very different to the staff versus the clinician. Self-destructive (mutilation) behavior can be seen in the more severe cases. Female patients can be very disarming. Their objective, in the chronic pain setting, relates more to issues of control and manipulation than to receiving effective pain management. Treatment can be intensive and involve residential placement. Use of controlled substances can be very dangerous. Patient with BPD are best referred to a specialist.

scholarly journals Accurate recording of personality disorder in clinical practice

2018 ◽  
Vol 42 (4) ◽  
pp. 135-136 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Psychiatric Disorder ◽  
Mental Disorder ◽  
Psychiatric Patients ◽  
Secondary Diagnosis ◽  
Official Statistics ◽  
Proper Understanding ◽  
Longitudinal Course

SummaryDisturbances of personality are recorded very poorly in official statistics, but there are signs that this is changing. For many years, personality disorder has been either regarded as a secondary diagnosis that can be forgotten in the presence of another mental disorder, or avoided as the diagnosis gives the impression of untreatability or stigma. What is now abundantly clear is that under-diagnosis of personality disorder represents a disservice to patients and practitioners. It prevents a proper understanding of the longitudinal course of psychiatric disorder and an appreciation of some of the positive aspects of abnormal personality that can be used in treatment. We must no longer bury personality disorder, ostrich-like, in the diagnostic sand. It is there for the asking and needs to be embraced honestly and without fear if we are to improve the management of psychiatric patients.Declaration of interestNone.

scholarly journals The distinction between personality disorder and mental illness

2002 ◽  
Vol 180 (2) ◽  
pp. 110-115 ◽  
Author(s):  
R. E. Kendell
Keyword(s):  
Mental Illness ◽  
Personality Disorder ◽  
Mental Disorder ◽  
Personality Disorders ◽  
Preventive Detention ◽  
Genetic Evidence ◽  
Mental Illnesses ◽  
Unresolved Issue ◽  
Basic Information ◽  
The Uk

BackgroundProposals by the UK Government for preventive detention of people with ‘dangerous severe personality disorders' highlight the unresolved issue of whether personality disorders should be regarded as mental illnesses.AimsTo clarify the issue by examining the concepts of psychopathy and personality disorder, the attitudes of contemporary British psychiatrists to personality disorders, and the meaning of the terms ‘mental illness'and ‘mental disorder’.MethodThe literature on personality disorder is assessed in the context of four contrasting concepts of illness or disease.ResultsWhichever of the four concepts or definitions is chosen, it is impossible to conclude with confidence that personality disorders are, or are not, mental illnesses; there are ambiguities in the definitions and basic information about personality disorders is lacking.ConclusionsThe historical reasons for regarding personality disorders as fundamentally different from mental illnesses are being undermined by both clinical and genetic evidence. Effective treatments for personality disorders would probably have a decisive influence on psychiatrists' attitudes.

Psychoactive substance abuse and personality disorders in psychiatric inpatients

2011 ◽  
Vol 26 (S2) ◽  
pp. 5-5
Author(s):  
C. Almonacid ◽  
A. Castillo ◽  
M. Lloret ◽  
M. Harto ◽  
A. Tatay ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Personality Disorder ◽  
Mental Disorder ◽  
Personality Disorders ◽  
Dual Diagnosis ◽  
Specific Treatment ◽  
Psychiatric Unit ◽  
High Association ◽  
Clinical Records

IntroductionComorbidity between Substance Use Disorder (SUD) and other psychiatric disorders, known as Dual Diagnosis, is an issue of growing interest in Mental Health. The high association between Personality Disorders (PD) and substance use is reported in scientific literature. However, not many studies have been published regarding the prevalence of this disorder in a psychiatric unit. AIMSTo determine the prevalence of substance abuse among patients with a Personality Disorder in a psychiatric unit.MethodologyA retrospective descriptive study was carried out among all patients admitted to our psychiatric unit during one year. The data collected from the discharge clinical records of patients were: demographic variables, personal psychiatric history and substance use, urine tests and clinical diagnoses at discharge.ResultsWe obtained a sample of 334 patients. There was comorbidity between Mental Disorder and SUD in 10.17% of subjects; including 4% diagnosed with Personality Disorder (80% belong to Cluster B). 53.3% of patients with PD substance abuse was reported. Excluding nicotine dependence and benzodiazepines, the most common substances used were cannabis (50%), alcohol (37.5%) and cocaine (25%).ConclusionsThis study shows that Personality Disorder is the Mental Disorder most commonly associated with SUD, among inpatients in our psychiatric unit. In order to detect cases of Dual Diagnosis, we suggest optimize recording in clinical history substance use and systematic urine tests in all patients admitted, which would benefit from specific treatment for their condition.

scholarly journals Problems of Psychopathy Concept in the Modern Domestic and Foreign Psychology

2016 ◽  
Vol 8 (1) ◽  
pp. 114-127 ◽  
Author(s):  
J.A. Atadjikova ◽  
S.N. Enikolopov
Keyword(s):  
Clinical Practice ◽  
Social Behavior ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Psychopathic Personality ◽  
Legal Practice ◽  
Psychological Mechanisms ◽  
The Subject ◽  
Definition Of ◽  
Terminological Confusion

The article raises the problem of the heterogeneity of the group of persons with antisocial behavior and the need for dividing it into subgroups. This problem can be solved by adopting psychology of the subject and his identity specifically as mediating process. Psychopathy as a personal anomaly acts as a link enables a clear assessment of anti-social behavior mechanisms in a particular group of individuals. We describe the understanding of psychopathy concept also known as antisocial (dissocial, psychopathic) personality disorder by domestic and foreign authors. The article discusses the main debating points of psychopathy role in clinical practice, definition of the diagnostic criteria, terminological confusion caused by the concept of antisocial (dissocial) personality disorders, as well as the search for the reasons and psychological mechanisms of psychopathy emergence and developing. Analysis of psychopathy relations with such constructs as aggression, violence and anti-social behavior, allows examining applied problems and the prospects of using the psychopathy construct in medical and legal practice.

scholarly journals Everything you wanted to know about neuroimaging and psychiatry, but were afraid to ask

2015 ◽  
Vol 21 (4) ◽  
pp. 251-260 ◽  
Author(s):  
Cristina Martinelli ◽  
Sukhwinder S. Shergill
Keyword(s):  
Clinical Practice ◽  
Psychiatric Disorder ◽  
Mental Disorder ◽  
Brain Structure ◽  
Imaging Techniques ◽  
Structure And Function ◽  
Everyday Clinical Practice ◽  
Brain Structure And Function ◽  
And Function ◽  
The Brain

SummaryRecent years have seen a dramatic increase in the advances and applications of medical imaging techniques. Tools with familiar acronyms such as MRI, EEG/MEG and PET/SPECT have provided invaluable information not only about the brain structure and function associated with psychiatric disorders, but increasingly about the mechanisms underpinning these disorders. This evolving understanding of the specific pathophysiology of mental disorder paves the way for improvement in the diagnosis, treatment and prognosis of the disorders managed in everyday clinical practice. This article gives an overview of the main neuroimaging approaches, contemporary applications of this technology to psychiatric disorder and signposts to the exciting possibilities for the future.

Mental and personality disorders and abstinence from alcohol: results from a national household survey

2010 ◽  
Vol 41 (4) ◽  
pp. 809-818 ◽  
Author(s):  
J. C. Skogen ◽  
A. Mykletun ◽  
C. P. Ferri ◽  
P. Bebbington ◽  
T. Brugha ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Alcohol Consumption ◽  
Mental Disorder ◽  
Personality Disorders ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Social Activity ◽  
Clinical Interview ◽  
Alcohol Abstinence ◽  
Low Alcohol

BackgroundThe beneficial outcomes associated with moderate compared with low alcohol intake or abstinence may be due to the inclusion of people as ‘low consumers’, who have stopped consumption because of poor health. We investigated the association between alcohol abstinence and symptoms of common mental disorder and personality disorder, distinguishing between lifelong abstinence and abstinence following previous consumption.MethodAnalyses were based on the British National Survey of Psychiatric Morbidity 2000, which sampled 8580 residents aged 16–74 years. Hazardous drinking (Alcohol Use Disorders Identification Test) was excluded. Symptoms of common mental disorder (depression/anxiety) were identified by the Clinical Interview Schedule. The screening questionnaire of the Structured Clinical Interview for Axis II Personality Disorders was used to identify potential personality disorder. Self-reported alcohol abstinence was divided into lifelong abstinence and previous consumption. Previous consumers were asked why they had stopped. Covariates included socio-economic status, social activity and general health status.ResultsAfter adjustment, alcohol abstinence was associated with both common mental disorder symptoms and any personality disorder, but only for previous consumers, in whom odds ratios were 1.69 (95% CI 1.23–2.32) and 1.45 (95% CI 1.09–1.94). Associations were non-specific, being apparent for most individual mental disorder symptoms and personality disorder categories. More detailed analysis indicated that associations were again limited to previous consumers who reported ceasing alcohol consumption for health reasons.ConclusionsWorse mental health in low alcohol consumers, particularly those who have previously ceased for health reasons, should be taken into account when interpreting associations between moderate (compared with low) alcohol consumption and beneficial health outcomes.

Trainee experience in diagnosis and management of personality disorders

2018 ◽  
Vol 37 (2) ◽  
pp. 136-140
Author(s):  
R. Wallace ◽  
G. Rush
Keyword(s):  
Clinical Practice ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Diagnostic System ◽  
Psychiatry Training ◽  
Linear Fashion ◽  
Diagnosis And Management ◽  
Training Structure ◽  
Trainee Experience

The diagnosis and management of personality disorders continues to evolve and develop alongside psychiatry internationally, however, not always in a linear fashion. Trainees working in a variety of clinical areas have regular exposure to personality disorder presentations. Psychiatry training bodies continue to adapt their training structure and curriculum, however, there seems to be a lack of sufficient emphasis with regards this area. We are now embarking on a new diagnostic system for personality disorders; this may impact on our clinical practice and perspective of these patients. The role of psychiatrists in diagnosing and managing personality disorders can be unclear at times and may benefit from on-going reflection and standardization.

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