scholarly journals Case Report: The Association Between Chromosomal Anomalies and Cluster A Personality Disorders: The Case of Two Siblings With 16p11.2 Deletion and a Review of the Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Cecilia Maria Esposito ◽  
Paolo Enrico ◽  
Domenico Sciortino ◽  
Elisabetta Caletti ◽  
Giulia Bruna Marchetti ◽  
...  

Although several studies have shown the correlation between chromosomal rearrangements and the risk of developing psychotic disorders, such as schizophrenia, little attention has been given to identifying the genetic basis of pre-disposing personality so far. In this regard, a limited but significant number of studies seem to indicate an association between chromosomal anomalies and cluster A personality disorders (CAPD). Starting from the clinical description of two brothers affected by familial 16p11 deletion syndrome (OMIM #611913), both sharing cluster A and C personality traits, the aim of the present study is to critically review the literature regarding the correlation between chromosomal rearrangements and CAPD. A bibliographic search on PubMed has been conducted, and eight studies were finally included in our review. Most of the studies highlight the presence of schizotypal personality disorder in the 22q11.2 deletion syndrome, whose evolutionary course toward psychotic pictures is well-known. One study also identified a paranoid personality disorder in a patient with a deletion on chromosome 7q21.3. No studies have so far identified the presence of paranoid personality disorder in 16p11 deletion, as in the case of the two siblings we report, while its association with psychosis and autism is already known. Although further epidemiologic studies on broader populations are indicated, our observations might pave the way for the definition of new diagnostic subgroups of CAPD and psychotic disorders, in order to implement the clinical management of such complex conditions.

2016 ◽  
Vol 6 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Jessa Koch ◽  
Taylor Modesitt ◽  
Melissa Palmer ◽  
Sarah Ward ◽  
Bobbie Martin ◽  
...  

Abstract Introduction: A personality disorder is a pervasive and enduring pattern of behaviors that impacts an individual's social, occupational, and overall functioning. Specifically, the cluster A personality disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Patients with cluster A personality disorders tend to be isolative and avoid relationships. The quality of life may also be reduced in these individuals, which provokes the question of how to treat patients with these personality disorders. The purpose of this review is to evaluate the current literature for pharmacologic treatments for the cluster A personality disorders. Methods: A Medline/PubMed and Ovid search was conducted to identify literature on the psychopharmacology of paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. There were no exclusions in terms of time frame from article publication or country of publication, in order to provide a comprehensive analysis; however, only articles that contained information on the cluster A disorders were included. Results: Minimal evidence regarding pharmacotherapy in paranoid and schizoid personality disorders was found. Literature was available for pharmacologic treatment of schizotypal personality disorder. Studies evaluating the use of olanzapine, risperidone, haloperidol, fluoxetine, and thiothixene did yield beneficial results; however, treatment with such agents should be considered on a case-by-case basis. Discussion: Most of the literature analyzed in this review presented theoretical ideas of what may constitute the neurobiologic factors of personality and what treatments may address these aspects. Further research is needed to evaluate specific pharmacologic treatment in the cluster A personality disorders. At this time, treatment with pharmacologic agents is based on theory rather than evidence.


Author(s):  
Sundeep Virdi ◽  
Robert L. Trestman

Personality disorders are highly prevalent and highly problematic in jails in prisons. Personality disorders, by definition, are associated with significant functional impairment of the affected individual and may negatively impact those around them. That impairment results from the way these individuals think and feel about themselves and others. Patients with personality disorder are often challenging to manage in the community. The difficulties associated with their care are accentuated in the confines and highly structured environments presented by jails and prisons. Inmates with personality disorders often require a disproportionate level of attention from correctional staff and their behavior can contribute to a dangerous environment inside a facility. Additionally, when compared to offenders with other psychiatric disorders or non-mentally disordered offenders, offenders with personality disorders have higher rates of violence, criminality, and recidivism. There are 4 personality disorders that are of particular clinical relevance to the correctional psychiatry setting: borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and paranoid personality disorder. Research also reflects that these disorders have the highest correctional prevalence rates among the personality disorders. For each of these four disorders, this chapter presents in turn a description and some management concerns and challenges, data on correctional prevalence, appropriate psychotherapy, and potential psychopharmacologic interventions.


Author(s):  
José Luis Carrasco ◽  
Dusica Lecic-Tosevski

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).


2007 ◽  
Vol 22 (3) ◽  
pp. 153-159 ◽  
Author(s):  
Brendan D. Kelly ◽  
Patricia Casey ◽  
Graham Dunn ◽  
Jose Luis Ayuso-Mateos ◽  
Christopher Dowrick

AbstractIndividuals with personality disorders (especially paranoid personality disorder) tend to be reluctant to engage in treatment. This paper aimed to elucidate the role of personality disorder in predicting engagement with psychological treatment for depression. The Outcomes of Depression International Network (ODIN) involves six urban and three rural study sites throughout Europe at which cases of depression were identified through a two-stage community survey. One patient in seven who was offered psychological treatment for depression had a comorbid diagnosis of personality disorder (most commonly paranoid personality disorder). Forty-five percent of patients who were offered psychological treatment for depression did not complete treatment. The odds of completion were higher for patients with a comorbid diagnosis of personality disorder, especially paranoid, anxious or dependent personality disorder. The relatively low number of cases with some specific personality disorders (e.g. schizoid personality disorder) limited the study's power to reach conclusions about these specific disorders. This study focused on a community-based sample which may lead to apparently lower rates of engagement when compared to studies based on treatment-seeking populations. Episodes of depression in the context of personality disorder may represent a valuable opportunity to engage with patients who might otherwise resist engagement.


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