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Co mmon Psychiatric Problems in Family Practice Personality Disorders

Co mmon Psychiatric Problems in Family Practice Personality Disorders. Saudi Diploma in Family Medicine Center of Post Graduate Studies i n F amily M edicine. Dr. Zekeriya Aktürk zekeriya.akturk@gmail.com www.aile.net. DSM - IV. 5-Axis model adopted in 1980 Axis 1

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Co mmon Psychiatric Problems in Family Practice Personality Disorders

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  1. Common Psychiatric Problems in Family Practice Personality Disorders Saudi Diploma in Family Medicine Center of Post Graduate Studies in Family Medicine Dr. Zekeriya Aktürk zekeriya.akturk@gmail.com www.aile.net / 17

  2. DSM - IV • 5-Axis model adopted in 1980 • Axis 1 • Clinical disorders (e.g., mood & anxiety disorders) • Axis 2 • Personality disorders (e.g., narcissism, antisocial) & mental retardation • Axis 3 • Medical (physical) conditions influencing Axis 1 & 2 disorders • Axis 4 • Psychosocial & environmental stress influencing Axis 1 & 2 disorders • Axis 5 • Global Assessment of Functioning score: highest level of functioning patient has achieved in work, relationships, and activities / 17

  3. Definitions • Personality - Usual Emotional + Behavioral Characteristics • Personality Traits - Components of Personality • Temperament - Affective Tone, Intensity, Reactivity • Character - Moral + Personality Traits / 17

  4. Paranoid Schizoid Schizotypal Antisocial Borderline Histrionic Narcissistic Avoidant Dependent Obsessive-Compulsive DSM IV Personality Disorders / 17

  5. Characteristics of PD • Relation to Axis I • 10% - 20% of General Population • Gender : ♂ASPD, Schizoid♀Avoidant, Dependent • Etiological Theories • Dynamic • Biological / Genetic / 17

  6. Paranoid PD • Pervasive Distrust + Suspiciousness, Interpret Motives as Evil • 4 + of : • Suspicious • Feels attacked • Preoccupation with distrust • Jealous • Won’t confide • Grudges • Misinterprets motives / 17

  7. Schizoid PD • Detached + Few Emotions • 4 + of : • Eschew (avoids) closeness • No close friends • Solitary • Indifferent • No sex interest • Cold • Not enjoy activities / 17

  8. Schizotipal PD • Discomfort with Relationships, Cognitive Distortions + Eccentric • 5 + of : • Ideas of reference • Odd magical beliefs • Perceptual disturbances • Odd thoughts/speech • Paranoia • Inappropriate affect • Odd behavior/appearance • Loner • Anxious socially / 17

  9. Antisocial PD (ASPD) • Disregard Rights of Others (and meet Conduct Disorder) • 3 + of : • Unlawful • Reckless • Deceitful • Irresponsible • Impulsive • Lack remorse • Aggressive / 17

  10. Borderline PD • Unstable Relationships, Affect, Self-Image Plus Impulsiveness • 5 + of : • Fears abandonment • Mood shifts • Unstable relationships • Feels empty • Changing self-Image • Anger • Impulsive sex, spending, etc • Temporary paranoia • Suicidal behavior / 17

  11. Histrionic PD • Excessive Emotionality, Attention Seeking • 5 + of : • Needs attention • Preens • Seductive • Dramatic • Mood shifts • Suggestible • Impressionistic, vague speech • Exaggerates relationships / 17

  12. Narcistic PD • Grandiose, Needs Admiration, Without Empathy • 5 + of : • Self important • Exploitative • Fantasies of success • Lacks empathy • Feels special • Envious • Needs admiration • Arrogant • Entitled / 17

  13. Avoidant PD • Inhibited, Inadequate, Sensitive • 4 + of : • Avoids social activity • Reluctant relationships • Fears intimacy • Fears criticism • Avoids new activities • Sees self inferior • Fears embarrassment / 17

  14. Dependent PD • Needs to be Taken Care of, Fears Separation • 5 + of : • Indecisive • Seeks nurturance • Avoids responsibility • Fears solitude • Avoids disagreements • Frantic for relationships • Lacks initiative • Fears abandonment / 17

  15. Obsessive – Compulsive PD • Orderliness, Perfectionist, Inflexible • 4 + of : • Detail oriented • Unable to discard • Perfectionism • Can’t delegate • Work oriented • Miserly • Over conscientious • Rigid / 17

  16. Passive – Aggressive PD • Negative Attitudes with Passive Resistance to Demands • 4 + of : • Passive • Envious, resentful • Misunderstood, unappreciated • Exaggerated complaints • Sullen, argumentative • Defiant then contrite • Scorns authority / 17

  17. Clusters A. Odd or Eccentric Paranoid, Schizotypal, Schizoid B. Dramatic or Erratic Antisocial, Histrionic, Borderline, Narcistic C. Anxious Avoidant, Obsessive – Compulsive, Dependent / 17

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