Personality Disorder - Psychiatry - Lecture Slides, Slides of Psychiatry

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Personality Disorders and Forensic Psychiatry Docsity.com Disorders of Adult Personality and Behaviour (F60-F69) F60 Specific personality disorders F61 Mixed and other personality disorders F62 Enduring personality changes, not attributable to brain damage and disease F63 Habit and impulse disorders F64 Gender identity disorders F65 Disorders of sexual preference F66 Psychological and behavioural disorders associated with sexual development and orientation F68 Other disorders of adult personality and behaviour F69 Unspecified disorder of adult personality and behaviour Docsity.com F60 Specific Personality Disorders • Personality disorder is persistent and appears already within late childhood and adolescence being fully manifested in adulthood (diagnosing after the age of 16-17 years) • The disorder is usually associated with significant problems in occupational and social performance • Causes of personality disorders are mostly genetic though the influence of upbringing, parent-child relationship and social environment play also their roles. Docsity.com F60.0 Paranoid Personality Disorder • Paranoid personality disorder - characterized by excessive sensitiveness to setbacks, persistent refusal to forgive insults and slights, suspiciousness, tendencies to misconstrue the neutral or friendly actions of others as hostile or contemptuous, suspiciousness concerning fidelity of sexual partner, tendencies to experience excessive self-importance and preoccupation with unsubstantiated conspiratorial explanations of events. • Personality (disorder): – expansive paranoid – fanatic – querulant – paranoid – sensitive paranoid Docsity.com F60.1 Schizoid Personality Disorder • Schizoid personality disorder - few activities provide pleasure, emotional coldness, limited capacity to express either warm or hostile feelings with indifference to either praise or criticism, little interest in having sexual experiences with another person, preference for solitary activities, excessive preoccupation with fantasy and introspection, lack of close friends and marked insensitivity to prevailing social norms and conventions. Docsity.com F60.4 Histrionic Personality Disorder • Histrionic personality disorder: – self-dramatization, pseudologia phantastica, exaggerated expression of emotions, enhanced suggestibility, shallow and labile affectivity, continual seeking for excitement, appreciation by others, and activities in which the patient is the centre of attention, over-concern with physical attractiveness together with inappropriate seductiveness, egocentricity, manipulative behaviour • Personality (disorder): – hysterical – psychoinfantile Docsity.com F60.5 Anankastic Personality Disorder • Anankastic personality disorder: – characterised by feelings of excessive doubts, preoccupation with details, perfectionism interfering with task completion, excessive conscientiousness and pedantry, rigidity – intrusion of insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder • Personality (disorder): – compulsive – obsessional – obsessive-compulsive Docsity.com F60.6 Anxious (Avoidant) Personality Disorder • Anxious (avoidant) personality disorder: – characterized by persistent and pervasive feelings of tension and apprehension, preoccupation with being criticized or rejected by others, avoidance of social or occupational activities because of fears of disapproval or rejection Docsity.com F62.0 Enduring Personality Change after Catastrophic Experience • Enduring personality change after catastrophic experience: – present for at least two years, following exposure to catastrophic stress – characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of "being on edge" as if constantly threatened, and estrangement. – enduring personality change after psychiatric illness (mostly schizophrenia) may appear due to the traumatic experience of suffering from a severe psychiatric illness • Personality change after: – concentration camp experiences – disasters – prolonged: • captivity with an imminent possibility of being killed • exposure to life-threatening situations such as being a victim of terrorism – torture Docsity.com Treatment of Personality Disorders • Psychotherapy – people who complain about lack of confidence and have difficulties in making relationships are usually motivated for psychotherapy – in emotionally unstable and dissocial personalities disorders the patient should recognize the situations which provoke his/her pathological reactions and should manage to avoid them – psychotherapy of personality disorders is a very difficult task and to reach a partial effect requests patient’s thorough motivation • Pharmacotherapy helps in emotional disorders – anxiolytics and SSRI antidepressants suppress anxiety and depressive symptoms – lithium and other thymoprofylactics (carbamazepin, valproic acid) reduces mood fluctuation and aggressive tendencies Docsity.com F63 Habit and Impulse Disorders F63 Habit and impulse disorders F63.0 Pathological gambling F63.1 Pathological fire-setting (pyromania) F63.2 Pathological stealing (kleptomania) F63.3 Trichotillomania F63.8 Other habit and impulse disorders F63.9 Habit and impulse disorder, unspecified Docsity.com F63.2 Pathological Stealing (Kleptomania) • Kleptomania - pathological stealing: – means that the patient suffers from intense impulses to steal objects that are not acquired for personal use or monetary gain – this disturbance may appear within the symptomatology of eating disorders Docsity.com F63.3 Trichotillomania • Trichotillomania: – characterized by noticeable hair loss due to a recurrent failure to resist impulses to pull out hairs Docsity.com F64 Gender Identity Disorders F64 Gender identity disorders F64.0 Transsexualism F64.1 Dual-role transvestism F64.2 Gender identity disorder of childhood F64.8 Other gender identity disorders F64.9 Gender identity disorder, unspecified Docsity.com The Law and Ordinary Psychiatric Practice • Consent to medical treatment and to hospitalization - the patient should be informed about the treatment procedures and probable side-effects of them to be able to give „informed consent”. • Compulsory admission and treatment (“admission without consent”) is realized in emergency situations (suicidal attempts, aggressive behaviour due to mental disorder towards other people, disorders of behaviour endangering patient’s life). A compulsory admission should be reported to the local court within 24 hours; the court will decide within one week’s period whether the admission has been justified. Docsity.com Civil Law • Testamentary capacity means that the individual is able to make a valid will. If there are some doubts about it, the validity of the testament can be challenged. The testator should be of „sound disposing mind” at the time of making it. • Four legal criteria: 1. the testator understands what a will is and what its consequences are 2. he knows the nature and extent of his property 3. he knows the names of close relatives and can assess their claims to his property 4. he is free from an abnormal state of mind. • Serious and persistent mental disorders cause incapacity of making decisions; the court appoints a guardian who is looking after patient’s affairs. Docsity.com Criminal Law • A person who committed a crime in a state of mental disorder undergoes psychiatric examination: – the expert gives a report on the mental state of the offender at the time of crime and on his/her present mental condition – according to the report conclusions the court decides about diminished or missing responsibility of the offender and about fitness to plead – if the offender is dangerous to other people on the ground of medical reasons the court can order compulsory treatment (psychiatric, antialcoholic, antitoxicomanic, sexuological) Docsity.com