1 / 17

Personality Disorders

Personality Disorders. Alison Hetherington. Case study. Patient Mrs H 64 years old Admitted to Heather ward on 23 rd December 2009 HPC Attempted suicide by taking paracetamol overdose Feels “dead inside” Claims to have no feelings for anyone including her family

ilori
Download Presentation

Personality Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Personality Disorders Alison Hetherington

  2. Case study • Patient • Mrs H • 64 years old • Admitted to Heather ward on 23rd December 2009 • HPC • Attempted suicide by taking paracetamol overdose • Feels “dead inside” • Claims to have no feelings for anyone including her family • Weight loss of 2 stones in 3 months

  3. PMHx • Hypertension • Recurrent UTI • Heart failure • Past Psych Hx • First engagement with services 1992 • Eating disorder section 3 admission for 6 months • Multiple OD attempts • DSH; burning/cutting/scalding • Diagnosed with depression treated with multiple antidepressants and ECT with no improvement

  4. Personal Hx • Difficult childhood • Abused by father and grandfather (sexual and emotional) • Lived in a children’s home • Divorced in 1989: abusive relationship • 3 children ages 39,37,35. Difficult relationship • No employment history • Friend Carolyn; Mrs H feel’s she takes advantage of her and bullies her

  5. Progress on the ward • Very little improvement • No response to medication or further course of ECT • Feel’s neglected and victimised by staff on the ward • Continues to self harm both on the ward and whilst on leave

  6. Personality Disorders

  7. What is ‘Personality’ ? • A collection of characteristics or traits that makes each of us an individual • These include the way we; • Think • Feel • Behave • Personality tends to be set by late teen’s • It is usually set for the rest of our lives

  8. Personality ‘Disorder’ When parts of our personality develop in a way that makes it difficult for us to live with ourselves and/or other people Unhelpful ways of thinking/feeling/behaving Deeply engrained Noticeable since childhood Maladaptive Resistant to change

  9. Characteristics • They may find it difficult to • make or keep relationships • get on with people at work • get on with friends and family • keep out of trouble • Control their feelings and/or behaviour

  10. Types; Cluster ASuspicious Paranoid Schizoid Schizotypal

  11. Types; Cluster BEmotional and impulsive • Antisocial, or Dissocial (psychopathic) • Borderline, or Emotionally Unstable • Histrionic • Narcissistic

  12. Types; Cluster CAnxious • Obsessive-Compulsive (aka Anankastic) • Avoidant (aka Anxious/Avoidant) • Dependent

  13. Aetiology? • Environmental and genetic factors • Neurodevelopmental theories • Psychoanalytical theories • Social circumstances • Parental deprivation • sexual abuse • impaired attachment

  14. Diagnosis Often a diagnosis of exclusion Clinical features should begin in adolescence, be stable over time and not only occur during an episode of mental illness Often concurrent mental illness Clinical classification unreliable and unhelpful

  15. Treatment strategies • Some improvement seen with age • Bio-psycho-social • Multidisciplinary team • Assessment of sources of distress to self and others • Diagnose co-morbid mental illness • Formulate realistic treatment goals

  16. Treatment continued…. • Medication used to treat specific symptoms • Mood stabilisers • Antipsychotics • Antidepressants • Psychosocial interventions • CBT • Supportive psychotherapy • Community outreach

  17. Summary • Personality disorder • Maladaptive and deeply engrained • High incidence of concurrent mental illness • Higher rates of suicide and accidental death • Often challenging to manage • Use bio-psycho-social model • Consider effect on your own mental health!

More Related