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Personality disorders are lifelong conditions that affect daily functioning. Diagnosis involves a thorough psychiatric history and meeting specific criteria in the DSM-IV. Personality disorders are listed on Axis II and are divided into three clusters. Treatment often involves psychotherapy and addressing comorbid disorders.
Personality disorders are psychiatric conditions characterized by lifelong impairment in everyday situations due to maladaptive personality traits or structures. Unlike other types of mental illness, personality disorders are lifelong conditions rather than episodic impairments. Evaluation for personality disorder involves a thorough psychiatric history, interaction with a health care provider, and, in some cases, psychological testing.
The Diagnostic and Statistical Manual (DSM-IV) is the book of guidelines used by mental health professionals to diagnose mental disorders. Specify the criteria needed for each type of personality disorder. These criteria must be met during a personality disorder evaluation to diagnose a person with a personality disorder.
The DSM-IV specifies that different types of mental illnesses are listed on different “axes”. Axis I is reserved for mental illnesses such as bipolar disorder, depression or schizophrenia. Axis II is used to indicate pervasive mental disorders that have been present for a long time. Personality disorders, as well as mental retardation, are specified in Axis II.
A personality disorder assessment is very difficult because personality disorders must affect a person throughout their life and in different situations. An extensive psychiatric history is required, taking into account traumatic events and daily social functioning throughout life and in different situations. Psychosocial functioning can vary widely among different individuals with personality disorders.
Comorbidity also complicates an assessment of personality disorder. Often a person with a personality disorder will also suffer from another mental illness. Some of the more common comorbidities include substance abuse and depression.
There are several types of personality disorders and they are divided into groups of similar disorders. Cluster A includes “weird” personality disorders, disorders characterized by odd behaviors and mannerisms. These disorders include paranoid, schizoid, and schizotypal personality disorders.
Cluster B includes personality disorders that interfere with impulse control and social functioning, such as antisocial personality disorder or borderline personality disorder. Cluster C includes personality disorders involving excessive dependence on certain people or rituals, such as avoidant, dependent, or obsessive-compulsive personality disorder. A personality disorder assessment must specify which personality disorder is present.
A personality disorder evaluation is the first step toward treatment. Psychotherapy is often the most effective and widely used treatment for personality disorders. Cognitive behavioral therapy can help a person change their unhealthy thinking and adopt healthy behaviors. Interpersonal psychotherapy can build social skills and improve daily functioning. Comorbid disorders such as depression or substance abuse can be treated with medication or therapy.
