Cluster A - Personality Disorders

DisorderEtiologyPresentationDiagnosisTreatment

Paranoid PersonalityPrevalence: 0.05-2.5%Men>Women

Higher incidence in family members of schizophrenias Long standing suspiciousness, hostility, irritability Distrust of others always right, challenges loyalty of friends Jealous Hypersensitive Poor self-image Question fidelity of significant other

Patients have a formal manner and seemed surprised to need psychiatric help4 or more of: Suspicion that others are deceiving them Reluctance to confide in others Interpretation of benign remarks as threatening or demeaning Persistence of grudges Perception of attacks of his/her character Recurrence of suspicions regarding fidelity of spouse or loverPsychotherapyNot group

Pharmacotherapy

Anti-anxiety agentsDiazepam (Valium) controls anxiety and agitation

Anti-PsychoticsHaloperidol (Haldol) manages severe agitation

Schizoid PersonalityPrevalence: 7%Men>Women

NO increased incidence of schizoid personality in families w/ history of schizophrenia Lifelong withdrawal Occurs in early childhood Aloof/removed affect There is no thought disorder or delusional thinking Ability to recognize reality Limited eye contact Results in unemotional parenting Exaggerated intimacy but only with one person

Patients appear ill at ease, rarely tolerate eye contact. Affect is constricted. Occasionally are unusual figures of speech.4 of More: Neither enjoying nor desiring close relationships Choosing solitary activities Little interest in sexual activity Taking pleasure in few activities Few close friends Indifference to praise or criticism DetachedPsychotherapy Patients tend toward introspection but often are agreeable w/ therapist Group settings patient often silent for long periods but become involved.

Pharmacotherapy Small dosages of antipsychotics, antidepressants and psychostimulants. SSRIs make pt less sensitive to rejection

DisorderEtiologyPresentationDiagnosisTreatment

Schizotypal PersonalityPrevalence: 3%

Signs and Symptoms: Very odd and magical thinking Ideas of reference Interpersonal deficits Decreased concentration

Other Signs: Peculiar mannerisms eccentric Speech is hard to follow NOT psychotic Severe social anxiety Chronic in nature and can progress to schizophrenia5 of More: Ideas of reference Magical thinking Unusual perceptual experiences Suspiciousness Inappropriate of restricted affect Odd or eccentric appearance or behavior Few close friends Odd thinking or speech Excessive social anxietyPharmacotherapy Antipsychotics useful in dealing with ideas of reference, illusions, and other symptoms Antidepressants should there be a depressive component Paranoid more aggressive in verbal behavior