Belle De Jour: A Case of Hysteria

IntroductionHistrionic Personality Disorder is one of the most common personality disorders diagnosed in Psychiatry. This disorder has been known to be present in more than 40% of patients. There is also a high tendency for those diagnosed with this disorder to be female.ObjectivesThe case is to show all the difficulties caused by this pathology, differencial diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.MethodsThe purpose is to study a clinical case of a 27-year-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. After that, she suffered several depressive episodes. At the moment, all the clinical symptoms support the diagnosis of histrionic personality disorder.ResultsHistrionic Personality Disorder can be found in the cluster B group of personality disorders. They often present in an overly dramatic, erratic or emotional manner. They may fulfil their need for attention through speech and behaviour that draws one's focus of attention toward themselves, and also demanding and manipulative in interpersonal relationships. There are high comorbidity rates in those who suffer from HPD with other diagnoses.ConclusionsHistrionic Personality Disorder appears to be one of the least threatening diagnosis among personality disorders as those affected are high functioning and do not seek relief for the disorder itself. There is also very little research on HPD which makes treatment options limitless.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A Serious Case of Hysteria

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1282 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S715-S715

Author(s):

A. Adrián ◽

C. Noval Canga ◽

M. Eduardo ◽

G. Sofía ◽

D.L.R. Henar ◽

...

Keyword(s):

Bipolar Disorder ◽

Differential Diagnosis ◽

Personality Disorders ◽

Clinical Case ◽

Daily Routine ◽

High Tendency ◽

Histrionic Personality Disorder ◽

Pharmacological Response ◽

Competing Interest ◽

Depressive Episodes

IntroductionHistrionic personality disorder (HPD) is one of the most common personality disorders diagnosed in Psychiatry. This disorder, although not thoroughly researched, has been known to be present in more than 40 percent of patients. There is also a high tendency for those diagnosed with this disorder to be female.ObjectivesThe purpose of this case is to show all the difficulties caused by this pathology, since differential diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.MethodsThe purpose is to study a clinical case of a 27-years-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. She did not remember what she had done during the dissociative episode. After that, she suffered several depressive episodes, and a pseudo hipomaniac episode, making the diagnosis of bipolar disorder, with no pharmacological response to lithium or lamotrigine.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Tools & Resources: Impairment and Disability Web Sites

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.novdec03 ◽

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.

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A New Look at Personality Disorders Treatments

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1868 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S506-S506

Author(s):

S. Neves ◽

J. Tudela

Keyword(s):

Personality Disorder ◽

Personality Traits ◽

Personality Disorders ◽

Evidence Base ◽

Primary Treatment ◽

Adjunctive Treatment ◽

Original Research ◽

Sociocultural Change ◽

Effective Interventions ◽

Competing Interest

IntroductionMental illness develops and is inseparable from the sociocultural context. The Disturbances may exhibit different symptoms in different cultures. In personality disorders, there is a pathological expansion of normal traits that often demonstrate a sociocultural change. The quality of life of these patients can improve with certain treatments, which appears to be relevant to be achieved.MethodSearch on Pubmed and Medline for original research or review articles published in English or Portuguese in the last 10 years. It used a combination of terms: “personality”, “treatment”, “personality disorder”, “borderline”, “antissocial”, “pharmacotherapy”, and other named personality disorders.Objectives/AimSearch the evidence base and the new perspectives for the effective treatment of personality disorders.ResultsThe same personality traits may be adaptive or non-adaptive in different contexts. So, without changing these characteristics, patients can learn to use them more effectively. In other words, although the therapy did not change the personality traits, it can be modified in the way they affect the behavioral expression.ConclusionsPsychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Personality Disorder in Perspective

The British Journal of Psychiatry ◽

10.1192/bjp.159.4.463 ◽

1991 ◽

Vol 159 (4) ◽

pp. 463-471 ◽

Cited By ~ 41

Author(s):

Peter Tyrer ◽

Patricia Casey ◽

Brian Ferguson

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Mental State ◽

Clinical Symptoms ◽

Psychiatric Practice ◽

The Past

Personality disorders have for many years been on the fringe of psychiatry, with considerable doubts expressed about the usefulness, implications and validity of the concept. It is argued here that developments in the past few years have brought personality disorders into the mainstream of psychiatric practice. In particular, the recognition that personality function can be separated usefully from clinical symptoms, and that both mental state and personality can be disordered simultaneously, has led to better assessment and understanding. Advances in the classification, epidemiology, treatment and prognosis of personality disorders show that these conditions are common, extensive in their pathology, and cause much suffering. They cannot be ignored or dismissed as peripheral to psychiatry for they are an essential part of good psychiatric practice.

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Paliperidone Palmitate Study in Patients With Personality Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1864 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S505-S505

Author(s):

M.A. Gutierrez Ortega ◽

D.P. María Dolores ◽

M.A. Manuel ◽

M.M. Esther

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Hospital Admissions ◽

Average Length ◽

Paliperidone Palmitate ◽

Emergency Visits ◽

Actual Clinical Practice ◽

Average Length Of Stay ◽

Psychopharmacological Treatment ◽

Competing Interest

IntroductionPersonality disorders are chronic affectation of mood, impulsivity, aggression and anxiety. It is thought to have biological factors related to the development of personality disorders.AimsTo evaluate and compare the efficacy of injectable paliperidone in actual clinical practice of patients diagnosed with Personality Disorder, compared to other treatments.MethodsWe conducted a descriptive, restrospective and observational study from January 2012 to June 2015 including all the patients who are treated with paliperidone palmitate extended-release injectable suspension with a diagnosis of Personality Disorder according to DSM 5. We included patients with at least 12 months of treatment and the results were compared with respect to the 12 months prior to taking said drug. Variables studied: medical diagnosis, hospital admissions, average length of stay, total number of emergency visits or other devices, maintenance doses.ResultsWe recruited 14 patients (7 women and 7 men) with a mean age of 36.2. 64.29% of patients had borderline personality disorder; 21.43% unspecified personality disorder. The mean dose of maintenance treatment is 105.357. Before the treatment, the quantity of total number of hospital admission are 1.14 versus 0.429 after treatment. The number of stay is also decreased from 13.7 to 3.5; like emergency room visits or to other devices. 78.57% of patients continue to psychopharmacological treatment. Fifty percent of patients undergoing treatment with another antipsychotic (P < 0.05).ConclusionsThe present results show that paliperidone palmitate can be an effective way to control the most characteristic symptoms of Personality Disorders, and reducing emergency visits, hospitalisations and other devices.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Personality Traits and Disorders Among Adult ADHD Patients: Is Borderline Personality Disorder as Common as we Expect?

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.060 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S258-S258 ◽

Cited By ~ 1

Author(s):

F. Oliva ◽

S. Bramante ◽

A. Portigliatti Pomeri ◽

C. Carezana ◽

G. Nibbio ◽

...

Keyword(s):

Personality Disorder ◽

Personality Traits ◽

Personality Disorders ◽

Adult Adhd ◽

Borderline Personality ◽

Personality Profiles ◽

High Prevalence ◽

Cluster A ◽

Competing Interest ◽

Low Prevalence

IntroductionPatients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.AimsTo explore the prevalence of personality traits and disorders among adult ADHD patients.MethodsMillon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).ResultsAccording to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.ConclusionsUnexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Histrionic Women in Iran: A Qualitative Study of the Couple Interactive Pathology of the Women with Symptoms of Histrionic Personality Disorder (HPD)

Review of European Studies ◽

10.5539/res.v9n1p18 ◽

2016 ◽

Vol 9 (1) ◽

pp. 18 ◽

Cited By ~ 2

Author(s):

Minasadat AlaviHejazi ◽

Maryam Fatehizade ◽

Fatemeh Bahrami ◽

Ozra Etemadi

Keyword(s):

Personality Disorder ◽

Qualitative Study ◽

Personality Traits ◽

Interpersonal Relationships ◽

Structured Interviews ◽

Healthy Relationships ◽

Histrionic Personality Disorder ◽

Sampling Process ◽

Data Collection Process ◽

Data Saturation

A variety of factors contribute to causes the couple’s vulnerabilities, including the personality traits that affect the couple’s healthy relationships. This study mainly aims to identify the couple’s vulnerabilities, notably women, with symptoms of the histrionic personality disorder. This is a qualitative study with a content analysis approach. The data collection process consists of 17 semi-structured interviews with the therapists, men with histrionic spouses, and the women with histrionic personality disorder, and using the related literature. The sampling process started purposefully and continued until data saturation. The data analysis led to the extraction of three categories including functional vulnerabilities, relationship vulnerabilities, and emotional vulnerabilities. Findings showed that personality traits of a histrionic woman dramatically affect the obvious individual behaviors and interpersonal relationships including couple’s relationships.

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Trauma-related dissociation: Psychological features and psycho-physiological responses to script-driven imagery in borderline personality disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1437 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S764-S764

Author(s):

D. Bichescu-Burian ◽

S. Jürgen ◽

S. Tilman ◽

T. Stefan

Keyword(s):

Heart Rate ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Clinical Symptoms ◽

Clinical Status ◽

Traumatic Events ◽

Borderline Personality ◽

Skin Conductance Responses ◽

History Of ◽

Competing Interest

BackgroundDefense reactions to threatening situations are vital adaptations to stress that protect organisms from injury and ensure survival. We retrospectively investigated the role of peritraumatic dissociation (PD) in the occurrence of severe psychopathology and dissociative patterns of reactions in borderline personality disorder (BPD).MethodsWe recruited 28 patients with a clinical diagnosis of BPD and 15 healthy controls. The BPD group was divided according to the level of PD (low vs. high): BPD and PD (n = 15) and BPD only (n = 13). We conducted an extensive investigation of history of trauma, clinical status, and measurements of emotional and physiologic responses to recall of personalized aversive experiences.ResultsParticipants with BPD and high PD displayed highest degrees of trauma exposure and clinical symptoms. Their significant heart rate decline during the imagery of personal traumatic events was opposed to the heart rate increases exhibited by the other two groups and may indicate a dissociative reaction pattern. Skin conductance responses did not differentiate between groups. Several emotional responses to imagery provided also support of the idea that PD may play a role in memory processing of traumatic events and thus in the aggravation and maintenance of symptoms in particularly severe forms of BPD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Personality Disorders and Suicide Attempts

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1867 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S506-S506

Author(s):

O.W. Muquebil Ali Al Shaban Rodriguez ◽

J.R. López Fernández ◽

C. Huergo Lora ◽

S. Ocio León ◽

M.J. Hernández González ◽

...

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Suicide Attempts ◽

Obsessive Compulsive ◽

Dsm 5 ◽

Patterns Of Behavior ◽

Cluster A ◽

Competing Interest ◽

Clear Relation ◽

Clinical Cases

IntroductionThe personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:– cluster A (strange subjects): paranoid, schizoid and schizotypal;– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.AimsTo describe the influence of personality disorders in suicide attempts.MethodologyExhibition of clinical cases.ResultsIn this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.ConclusionsThe personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Investigation of the clinical functioning of the Attention Seeking of the Dimensional Clinical Personality Inventory

Psicologia ◽

10.17575/rpsicol.v30i1.1072 ◽

2016 ◽

Vol 30 (1) ◽

pp. 49-60 ◽

Cited By ~ 1

Author(s):

Lucas De Francisco Carvalho ◽

Catarina Sette ◽

Cláudio G. Capitão

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Roc Curve ◽

Rating Scale ◽

Personality Inventory ◽

Scale Model ◽

Reliability Measures ◽

Histrionic Personality Disorder ◽

Pathological Characteristics ◽

Rating Scale Model

The aim of this study was to investigate the clinical functioning of one of the dimensions of the Dimensional Clinical Personality Inventory (IDCP), Attention Seeking, and to establish a cutoff considering the diagnosis of histrionic personality disorder, whose pathological characteristics are directly related to this dimension. The IDCP was applied to 1954 participants (62.20% women), between 18 and 90 years (M = 29.30, SD = 11.38), divided into three groups: patients with histrionic personality disorders (n = 14), patients with other personality disorders (n = 168), and those without diagnoses (n = 1772). The parameters of items and persons were estimated by the rating scale model, and reliability measures were generated, as well as the item-person map and map of items, ANOVA for comparison between groups, and ROC curve. The results suggest suitability of the Attention Seek dimension in clinical functioning; however, problems that seem inherent to the histrionic personality disorder were reflected in the setting of the dimension.

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