Tools & Resources: Impairment and Disability Web Sites

1999 ◽  
Vol 4 (6) ◽  
pp. 5-6
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Interpersonal Relationships ◽  
Web Sites ◽  
Outpatient Psychotherapy ◽  
Obsessive Compulsive ◽  
Not Otherwise Specified ◽  
Cluster B Personality Disorders ◽  
Clinically Significant ◽  
And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

Specific types of personality disorder

2012 ◽  
pp. 861-881 ◽  
Author(s):  
José Luis Carrasco ◽  
Dusica Lecic-Tosevski
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Personality Change ◽  
Obsessive Compulsive ◽  
Schizotypal Personality ◽  
General Medical Condition ◽  
Personality Changes ◽  
Paranoid Personality Disorder ◽  
Paranoid Personality ◽  
Cluster B Personality Disorders

This chapter begins by discussing the epidemiology, aetiology, clinical picture, course, differential diagnosis, and treatment of various Cluster A personality disorders (Paranoid personality disorder, paranoid personality disorder, schizotypal personality disorder), Cluster B personality disorders (antisocial personality disorder, borderline personality disorder (BPD), histrionic personality disorder, narcissistic personality disorder) and Cluster C personality disorders (avoidant personality disorder, dependent personality disorder (JLC), and obsessive–compulsive (anankastic) personality disorder). Other personality disorders (not included in DSM-IV) are also covered, including passive–aggressive (negativistic) personality disorder, self-defeating (masochistic) personality disorder, sadistic personality disorder, depressive personality disorder, and personality changes, including enduring personality changes after traumatic experiences and personality change due to a general medical condition (JLC).

Obsessive-Compulsive Personality Disorder

2012 ◽  
pp. 565-581
Author(s):  
Jack Samuels ◽  
Paul T. Costa
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Positive Emotions ◽  
Factor Model ◽  
Five Factor Model ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Clinically Significant ◽  
Obsessive Compulsive Personality Disorder ◽  
Over Time

Obsessive-compulsive personality disorder (OCPD) has been described in the clinical literature for over 100 years. Although the specific traits included in the construct have changed over time, there is remarkable consistency in the core concept. OCPD is clinically significant, given its relatively high prevalence in the community, its frequent co-occurrence with mood disorders, anxiety disorders, especially obsessive-compulsive disorder, and eating disorders, and treatment challenges. Although OCPD can be quite severe, it is generally less impairing than other personality disorders in the clinic, and it has not been found to be strongly related to functional impairment in the community. OCPD has excellent construct validity, but concerns have been raised about the stability over time and the reliability of assessment. OCPD may be alternatively construed dimensionally, with high conscientiousness as an important feature. Like other personality disorders, OCPD is better understood and described in terms of a combination of traits or facets rather than as reflecting a single domain of personality. In this regard, a number of studies illuminate the contribution of high neuroticism, low openness to actions and values, low agreeableness, and low extraversion facets of warmth and positive emotions. Finally, there are many advantages to tying personality disorders, and especially OCPD, to established dimensions of general personality because a great deal is already known about the dimensions of the Five-Factor Model.

Assessing Suicide Risk in Cluster C Personality Disorders

Crisis ◽  
2004 ◽  
Vol 25 (3) ◽  
pp. 128-133 ◽  
Author(s):  
Andrea P. Chioqueta ◽  
Tore C. Stiles
Keyword(s):  
Personality Disorder ◽  
Depressive Disorder ◽  
Personality Disorders ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Psychiatric Outpatients ◽  
Obsessive Compulsive ◽  
Cluster B Personality Disorders ◽  
Axis I ◽  
Cluster A

Abstract: The aim of the study was to assess suicide risk in psychiatric outpatients with specific cluster C personality disorders (avoidant, dependent, and obsessive-compulsive). A sample of 142 psychiatric outpatients was used for the study. The sample was composed of 87 outpatients meeting diagnostic criteria for a personality disorder and 53 psychiatric outpatients meeting criteria for an axis I disorder only. The results showed that dependent, but not avoidant or obsessive-compulsive, personality disorders, as well as the clusters A and B personality disorders, were significantly associated with suicide attempts. This association remained significant after controlling for both a lifetime depressive disorder and severity of depression for the cluster A and the cluster B personality disorders, but not for dependent personality disorder. The results underline the importance of assessing suicide risk in patients with cluster A and cluster B personality disorders, while the assessment of suicide risk in patients with cluster C personality disorders seems to be irrelevant as long as assessment of a comorbid depressive disorder is appropriately conducted.

scholarly journals Psychiatric, demographic and personality characteristics of elderly sex offenders

2002 ◽  
Vol 32 (2) ◽  
pp. 219-226 ◽  
Author(s):  
S. FAZEL ◽  
T. HOPE ◽  
I. O’DONNELL ◽  
R. JACOBY
Keyword(s):  
Mental Illness ◽  
Personality Disorder ◽  
Sex Offenders ◽  
Personality Traits ◽  
Personality Disorders ◽  
Psychiatric Morbidity ◽  
The Elderly ◽  
Personality Factors ◽  
Obsessive Compulsive ◽  
Dsm Iv

Background. Psychiatric disorders are purported to play a role in the aetiology of violent crime, but evidence for their role in sexual offending is less clear. The authors investigated the prevalence of psychiatric morbidity and personality disorders in elderly incarcerated sex offenders compared with elderly non-sex offenders.Method. One hundred and one sex offenders and 102 non-sex offenders aged over 59 years were interviewed using standardized semi-structured interviews for psychiatric illness (the Geriatric Mental State) and the personality disorder (Structured Clinical Interview for DSM-IV personality disorders). Data on demographic, offence and victim characteristics were collected.Results. Six per cent of the elderly sex offenders had a psychotic illness, 7% a DSM-IV major depressive episode and 33% a personality disorder; and 1% had dementia. These prevalence figures were not different from the elderly non-sex offenders interviewed in this study. Differences emerged at the level of personality traits with sex offenders having more schizoid, obsessive–compulsive, and avoidant traits, and fewer antisocial traits compared with non-sex offenders.Conclusions. Elderly sex offenders and non-sex-offenders have similar prevalence rates of mental illness. However, elderly sex offenders have increased schizoid, obsessive–compulsive, and avoidant personality traits, supporting the view that sex offending in the elderly is associated more with personality factors than mental illness or organic brain disease.

Working with Personality Disorders in an Integrated Care Setting

2017 ◽  
Author(s):  
Robert E. Feinstein ◽  
Joseph V. Connelly
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Integrated Care ◽  
Care Pathway ◽  
Diagnostic Testing ◽  
Care Team ◽  
Obsessive Compulsive ◽  
Medical Settings ◽  
Obsessive Compulsive Personality Disorder ◽  
The Impact

Patients with personality disorders are common in primary care and medical settings. They can elicit intense problematic reactions from the members of an integrated care team, which can affect the team’s evaluation, diagnoses, diagnostic testing, medical orders, medications, laboratory tests, treatments, recommendations, and referrals. The four most common and challenging personality disorders are borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and obsessive-compulsive personality disorder. This chapter reviews the classification, epidemiology, biological basis, psychosocial formulation, and co-occurring mental health disorders associated with these personality disorders. A personality disorder schema is presented for managing these difficult patients. The impact these patients can have on the integrated care team is described. A care pathway is outlined that can be used for management, brief treatment, and referral for treatment to a personality disorder specialist.

Pattern of Comorbidity Among Anxious and Odd Personality Disorders: The Case of Obsessive-Compulsive Personality Disorder

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 23-26 ◽  
Author(s):  
Alessandro Rossi ◽  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Artemis Kalyvoka ◽  
Concetta Petruzzi
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Odds Ratios ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Cluster A ◽  
Obsessive Compulsive Personality Disorder

AbstractThe aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the “odd” PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C (“anxious”) PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.

Personality disorders and depression

2002 ◽  
Vol 32 (6) ◽  
pp. 1049-1057 ◽  
Author(s):  
M. FAVA ◽  
A. H. FARABAUGH ◽  
A. H. SICKINGER ◽  
E. WRIGHT ◽  
J. E. ALPERT ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Personality Disorders ◽  
Antidepressant Treatment ◽  
Significant Proportion ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Before And After

Background. Personality disorders (PDs) were assessed among depressed out-patients by clinical interview before and after antidepressant treatment with fluoxetine to assess the degree of stability of PD diagnoses and determine whether changes in PD diagnoses across treatment are related to the degree of improvement in depressive symptoms.Method. Three hundred and eighty-four out-patients (55% women; mean age = 39.9±10.5) with major depressive disorder (MDD) diagnosed with the SCID-P were enrolled into an 8 week trial of open treatment with fluoxetine 20 mg/day. The SCID-II was administered to diagnose PDs at baseline and endpoint.Results. A significant proportion (64%) of our depressed out-patients met criteria for at least one co-morbid personality disorder. Following 8 weeks of fluoxetine treatment, there was a significant reduction in the proportion of patients meeting criteria for avoidant, dependent, passive-aggressive, paranoid and narcissistic PDs. From baseline to endpoint, there was also a significant reduction in the mean number of criteria met for paranoid, schizotypal, narcissistic, borderline, avoidant, dependent, obsessive–compulsive, passive aggressive and self-defeating personality disorders. While changes in cluster diagnoses were not significantly related to improvement in depressive symptoms, there were significant relationships between degree of reduction in depressive symptoms (percentage change in HAM-D-17 scores) and degree of change in the number of criteria met for paranoid, narcissistic, borderline and dependent personality disorders.Conclusions. Personality disorder diagnoses were found to be common among untreated out-patients with major depressive disorder. A significant proportion of these patients no longer met criteria for personality disorders following antidepressant treatment, and changes in personality disorder traits were significantly related to degree of improvement in depressive symptoms in some but not all personality disorders. These findings suggest that the lack of stability of PD diagnoses among patients with current MDD may be attributable in part to a direct effect of antidepressant treatment on behaviours and attitudes that comprise PDs.

scholarly journals Unrecognised psychopathology in patients with difficult asthma: major mental and personality disorders

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Lonneke C.J. Prins ◽  
Maarten J.M. van Son ◽  
Anton R.J. van Keimpema ◽  
Jan-Willem G. Meijer ◽  
Martina E.F. Bühring ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorder ◽  
Personality Disorders ◽  
Psychiatric Treatment ◽  
Somatoform Disorders ◽  
Diagnostic Interview ◽  
Obsessive Compulsive ◽  
Clinical Interviews ◽  
Major Mental Disorder ◽  
Difficult Asthma

BackgroundDifficult asthma is a severe subgroup of asthma in which the main feature is uncontrollability of symptoms. Psychopathology is suggested to be prominent in patients with difficult asthma and considered important in its treatment; however, the evidence is scarce.AimsTo describe psychopathology in difficult asthma, both major mental and personality disorders, based on diagnostic interviews.MethodThis study was conducted in a specialised asthma care centre. A total of 51 patients with difficult asthma were diagnosed at the start of the treatment programme using two structured clinical interviews for both major mental (SCID-I) and personality disorders (SCID-II) according to DSM-IV-TR.ResultsAbout 55% of the patients with difficult asthma had a psychiatric disorder of which 89% was undiagnosed and untreated before being interviewed. About 49% had a minimum of one major mental disorder of which the cluster of anxiety disorders was the most common cluster of major mental disorders, followed by somatoform disorders. About 20% were diagnosed with a personality disorder. Of the 10 patients with a personality disorder, 9 had an obsessive-compulsive personality disorder.ConclusionsThis study demonstrates that more than half of patients with difficult asthma had a psychiatric disorder of which 89% was unrecognised. This study highlights the importance of offering patients with difficult asthma a psychiatric diagnostic interview and/or a psychiatric consultation as part of their routine medical examination and provision of appropriate psychiatric treatment. Moreover, it highlights the urgency of further research into the role of psychopathology in the development of difficult asthma.

scholarly journals Diagnostic neglect: The potential impact of losing a separate axis for personality disorder

2015 ◽  
Vol 206 (5) ◽  
pp. 355-356 ◽  
Author(s):  
Giles Newton-Howes ◽  
Roger Mulder ◽  
Peter Tyrer
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Empirical Evidence ◽  
Borderline Personality ◽  
Axis Ii ◽  
Not Otherwise Specified ◽  
Potential Impact

SummaryBoth major classifications in psychiatry have now moved away from the multi-axial nosological model. This is clinically understandable as the specific categorical diagnoses, other than borderline personality disorder and personality disorder ‘NOS' (not otherwise specified) were so seldom used and empirical evidence would not support the polythetic categorical system. As a consequence, those with personality disorders, frequently referred to as Axis II disorders, now have to compete with all other mental disorders for clinical attention.

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