Mental health articles
OF mental health care and mentally ill
Assessment of personality disorder
Patients with personality disorder may present with a range of behavioural, emotional or associated problems.
Enduring personality changes
Previous personality may change permanently after catastrophic experiences in adult life (such as hostage-taking, torture or other disaster) or severe mental illness
Common presentations of personality disorder
Aggression Anxiety and depression
Bingeing, vomiting, purging and other eating problems
Alcohol and substance misuse
Deliberate self-harm
Those with Cluster A problems may be less likely to present, but the distinction to be made will be between personality disorder and psychotic illness. For Cluster B, aggression (toward themselves or others), fluctuating mood, anxiety, depression, problems with eating, alcohol and substance misuse, may be the initial presenting features.
In Cluster C disorders, depression and anxiety may predominate. Assessment involves taking a detailed history with particular attention to early experience, behaviour and events, in addition to the individual’s reaction to them and the context in which they occurred. The individual’s personal history is continued into adulthood, covering work, relationships, alcohol and substance misuse, forensic history and current social circumstances.
The aims are to establish whether there are recurring patterns of behaviour or emotional response and the impact of any emerging patterns on relationships, work and overall level of function. The individual’s psychiatric and medical histories are important in identifying any exclusion to the diagnosis, past interventions and their effects positive or negative. Mental state examination is needed to identify comorbid conditions or exclusions.
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Tags: assessment, disorder, Personality Disorder
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