1. Personality disorders

2. Personality disorders
Enduring pattern of inner experience and behavior that differs markedly from the expectations of the individual's culture
Behaviour pattern is pervasive and inflexible
Maladaptive pattern of perceiving and responding to other people and to stressful circumstances
Onset in adolescence or early adulthood
Stable over time
Leads to distress or impairment

3. Types of personality disorders
Clusters
Personality disorders
Cluster A: Odd, eccentric
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder
Cluster B: Dramatic, emotional
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder
Cluster C: Anxious, fearful
Avoidant personality disorder
Dependent personality disorder
Obsessive-compulsive personality disorder

4. Personality disorders prone for drug use
Antisocial personality disorder
Borderline personality disorder
Narcissistic personality disorder
Paranoid personality disorder

5. Antisocial personality disorder
Display a pervasive pattern of disregard for and violation of the rights of others and the rules of society
Onset by age 15 years
Features
Repeated violations of the law
Pervasive lying and deception
Physical aggressiveness
Reckless disregard for safety of self or others
Consistent irresponsibility in work and family environments
Lack of remorse

6. Borderline personality disorder
Pervasive pattern of unstable and intense interpersonal relationships, self-perception, and moods
Transiently, such patients may appear psychotic
Features (at least five of the following)
Frantic efforts to avoid expected abandonment
Unstable and intense interpersonal relationships
Markedly and persistently unstable self-image
Impulsivity in at least 2 areas that are potentially self-damaging (eg, sex, substance abuse, reckless driving)
Recurrent suicidal behaviors or threats or self-mutilation
Affective instability
Chronic feelings of emptiness
Inappropriate and intense anger
Transient paranoia or dissociation

7. Narcissistic personality disorder
Patients are grandiose and require admiration from others
Features
Exaggeration of their own talents or accomplishments
Sense of entitlement
Exploitation of others
Lack of empathy
Envy of others
An arrogant, haughty attitude

8. Paranoid personality disorder
Display pervasive distrust and suspiciousness
Features
Others are exploiting or deceiving the person
Friends and associates are untrustworthy
Information confided to others will be used maliciously
There is hidden meaning in remarks or events others perceive as benign
The spouse or partner is unfaithful

9. Etiology of personality disorders
Antisocial personality disorder:
A genetic contribution to antisocial behaviors
There may also be developmental or acquired abnormalities in the prefrontal brain systems and reduced autonomic activity
Borderline personality disorder:
High prevalence of early abuse (sexual, physical, and emotional)
Mood disorders in first-degree relatives
Paranoid personality disorder:
A genetic contribution to paranoid traits
A possible genetic link between this personality disorder and schizophrenia exist

10. Treatment
Psychotherapy is at the core of care for personality disorders
Cognitive behaviour therapy identifies the distortions and engages the patient in efforts to reformulate perceptions and behaviors
Group psychotherapy allows interpersonal psychopathology to display itself among peer patients, whose feedback is used to identify and correct maladaptive ideas, communication, and behavior
Dialectical behavior therapy is useful in borderline personality disorders

11. Patient/family education
Share personality disorder with the patient and educate families on the disorder
Work with patient and family to identify the most troublesome behaviours and work with them on alternative responses and to anticipate triggers
Therapeutic relationship is prerequisite for change
Disorders can be frustrating to treat and require time and patience