Personality disorder in perspective

Article Abstract:

Personality disorder cannot be ignored but the term has been abused. Because of its use as a catch-all diagnostic category to label those who are thought to be untreatable, patients diagnosed with personality disorders are too often seen as malicious, difficult, and manipulative. The recognition of personality disorder is rooted in early cultures and was often referred to as ''character.'' The principles have changed over the years, but today the diagnosis remains ambiguous. This is, in part, because the very concept of personality is difficult to define; all brief definitions lose important elements. Personality disorder involves persistent behavior, attitudes, and the experience of distress, and has an effect on relationships. It also needs to be considered separately from mental state. The recent interest in diagnosing personality disorder separately from mental illness has shown that personality disorder is more prevalent than previously thought; in clinical populations, the prevalence estimates range from about 4 to 8 percent to upwards of 34 percent. Most commonly, these are associated with diagnoses of alcohol abuse and anxiety. Prevalence estimates among those who have attempted suicide are as high as 48 to 65 percent. It has long been accepted that personality disorders are not treatable, but this assumption should be open to question. Treatment may be long and difficult, but drug and psychological studies have recently suggested that personality disorder may be treatable after all. The most pressing need is for unbiased measurements of personality so that diagnosis and treatment of personality disorder can follow. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnostic and Statistical Manual of Mental Disorders (Book)

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Efficacy of combined antidepressant therapy in resistant neurotic disorder

Article Abstract:

The combined use of different antidepressants in therapy is not common and is generally shunned. This is because of concern over the safety of the practice, which led to a formal recommendation against it in the 1960s. It is suggested now that many of the reports of danger may have been exaggerated, and there is some renewed interest in the combination of two types of antidepressants: monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants. Assuming that safety is not a factor, there is still little published information on the usefulness of the two drugs administered in combination, as compared with the usefulness of either when administered alone. In a case history, it is shown that a 35-year-old woman suffering from depression and phobias did not respond to either MAOIs or tricyclic antidepressant medication when each was administered alone. She did, however, respond favorably to a combination of the two. When the MAOI was replaced by a placebo, her condition again deteriorated within two weeks, resulting in an increase in both depressive and anxiety symptoms. This suggests that the combined use of MAOIs and antidepressants may be desirable in cases of seemingly untreatable depression and anxiety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Depression, Mental, Depression (Mood disorder), Antidepressants, Anxiety, Drug therapy, Combination, Combination drug therapy, Neuroses

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Personality disorder and psychiatric illness in general practice

Article Abstract:

There have been studies on the prevalence of psychiatric illnesses seen in general medical practice, but little has been done with regard to the prevalence of personality disorders. Personality can affect symptom patterns, outcome, and treatment in medical situations; it may be assumed that the same holds true for psychiatric illness. Over a one-year period, the prevalence of psychiatric disorders in two medical practices was assessed by a psychiatrist and a general practitioner. The prevalence of personality disorder was about 5.5 percent in both practices, as determined by a standard interview. When a structured interview was used, however, the prevalence of personality disorder was 28 percent. It is suggested that the higher figure is probably more accurate, and it is recommended that practitioners be more willing to assess this potentially important component of their patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Statistics, Mental illness, Mental disorders

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