Personality Disorders (PD) Summary (print version)

Size: px
Start display at page:

Download "Personality Disorders (PD) Summary (print version)"

Transcription

1 Personality Disorders (PD) Summary (print version) 1/ Definition A Personality Disorder is an abnormal, extreme and persistent variation from the normal (statistical) range of one or more personality attributes (traits), causing the individual and/or family and/or society to suffer. A diagnosis is unlikely to be given before age 16 or 17. It is important to distinguish from mental illness (they may coexist in clinical practice and both can result in an abnormal mental state & behavioural). It not only increases vulnerability to mental illness, but also worsens the course and treatment response especially in depression, anxiety and alcohol & drug abuse. 2/ Classification ICD (International Classification of Disease)-10 published in 1992, is used in all countries. PD is under Chapter V with Codes: F60 - Specific PD F61 - Mixed and other PD F62 - Enduring personality changes, not attributable to brain damage and disease DSM (Diagnostic and Statistical Manual of Mental Disorders) - 5 published in 2013 by the American Psychiatric Association for use in America - DSM-5 (compare to the DSM-IV) has moved from the multi-axial to a mono-axial system used under DSM-4, so that removes the arbitrary boundaries between personality disorders and other mental disorders. However, the same ten types of personality disorder are retained. - DSM-5 use three clusters (and this classification structure is not found in ICD-10: Cluster A Odd, bizarre, eccentric Cluster B Dramatic, erratic Cluster C Anxious, fearful

2 ICD-10 DSM-5 Note: Paranoid Paranoid (Cluster A) Schizoid Schizoid (Cluster A) (Schizotypal) Schizotypal (Cluster A) Dissocial Antisocial (Cluster B) Emotionally unstable Borderline (Cluster B) Impulsive type Borderline type Histrionic Histrionic (Cluster B) - Narcissistic (Cluster B) Anankastic (OC) Obsessive-Compulsive (Cluster C) Anxious (avoidant) Avoidant (Cluster C) Dependent Dependent (Cluster C) - Passive-aggressive In ICD-10, Schizotypal PD (F21) is no longer included under PD but alongside schizophrenia as schizotypal disorder In ICD-10, Narcissistic PD (F60.8 other PD) & Passive-aggressive PD (for further study) are not included In ICD-10 and DSM-5, Multiple PD is classified under Dissociative disorders (F44.81) In DSM-5, Cluster not specified for Passive Aggressive; Depressive; Sadistic; Self-defeating (Masochistic); Psychopathy PD In DSM-5, Emotionally unstable PD, Impulsive type (F60.30) & Enduring Personality changes (F62) are not included 3/Epidemiology 10% of population Up to 50% of psychiatric patients : % psychiatric ward % of psychiatric patients treated in the community Around 10-30% of patients - GP More commonly diagnosed between the ages of 18 and 35, in males, in lower social class and less education - Antisocial PD more common among men - Borderline / Histrionic PD more frequently in women

3 4/ Aetiology Genetic factors 1. XYY increased criminality 2. 1 st degree relatives of patients with Borderline PD are 10 x more likely to be treated for Borderline PD Neurophysiology low level of 5-hydroxytryptamine metabolite was found in the cerebrospinal fluid in patients with impulsive and aggressive behaviour Prenatal effects 1. impaired nutrition during pregnancy 2. hypoxia at birth 3. birth complications Childhood development & Early life experiences 1. parenteral loss 2. trauma physical / emotional / sexual abuse 3. social learning in childhood - maternal deprivation / attachment issues / lack of consistent rules in the family / growing up in an antisocial family 4. violence in family 5. behavioural problems in childhood - sever aggression / disobedience / repeat temper tantrums 6. parents using excessively drugs incl alcohol Brain disease / head injury minor degrees of brain injury might be a cause of antisocial personality (otherwise classified under organic mental disorders) Some people with antisocial personality disorder have very slight differences in the structure of their brains, and in the way some chemicals work in their brains. However, there is no brain scan or blood test for a personality disorder. Psychodynamic theories Cognitive behavioral theories Triggers 1. using a lot of drugs or alcohol 2. problems getting on with your family or partner 3. money problems 4. anxiety, depression or other mental health problems 5. important events 6. stressful situations

4 5/ Assessment Accurate assessment of enduring and pervasive pattern of emotional expression, interpersonal relationships, social functioning, views of self and other Information from other sources Good history Describe interference with functioning occupational, family, relationships, offending Coping strategies Instruments: 1. Self-rated questionnaire (Personality diagnostic questionnaire, Personality assessment inventory) 2. Observed-rated structured interview (International PD Examination) 3. Interview based (Structure clinical interview, Psychodynamic formulation) 4. other - Rorschach test, Thematic apperception test 5. Diagnostic Interview schedule 6. Psychopathy checklist revised 7. Borderline personality disorder scale 6/ Differential Diagnosis The principal differential diagnosis of PD is from affective disorders, substance misuse, psychotic disorders, anxiety disorders (especially phobia and panic disorder), obsessive-compulsive disorder, learning disability, dementia, and autism. 7/ Management PD are lifelong disorders but many tend to improve in middle and old age. Important complications include depressive disorder, substance misuse, and deliberate self-harm and suicide. General points to consider in planning and delivering treatment for PD: What sort of disorder is it? How severe is it? How far has it spread? Is there co-morbid illness? What is their attitude to help-seeking or eliciting? Are they actively psychotic, addicted or depressed?

5 No single treatment approach Bio-Psycho-Social: The type of therapy or treatments offered depends on: what patient with PD wants or prefers the type of difficulties he/she has what is available locally Therapeutic relationship important! Individual needs Managing comorbid disorders (incl medication) Managing crisis Admission - Medication Psychological Therapies Specialist services Outcome: Morbidity and mortality high rates of accidents, suicide, violent detah (esp. cluster B), high rate of other mental disorders Over time some evidence cluster A worsen with age, cluster B improve, cluster C unchanged Management plan for PD within the UK Based on national guidelines for the treatment of PD F60 NICE 2009 a,b 1. Biological: medication Antipsychotic drugs (usually at a low dose) 1. Can reduce the suspiciousness of the three cluster A personality disorders (paranoid, schizoid and schizotypal). 2. Can help with borderline personality disorder if people feel paranoid, or are hearing noises or voices Antidepressant 1. Can help with the mood and emotional difficulties that people with cluster B personality disorders (antisocial or dissocial, borderline or emotionally unstable, histrionic, and narcissistic) have 2. Some of the selective serotonin reuptake inhibitor antidepressants (SSRIs) can help people to be less impulsive and aggressive in borderline and antisocial personality disorders 3. Can reduce anxiety in cluster C personality disorders (obsessivecompulsive, avoidant and dependent) Mood stabilisers Medication such as lithium, carbamazepine, and sodium valproate can also reduce impulsiveness and aggression.

6 2. Psychological: talking treatments or therapies A number of psychotherapies seem to work well, particularly for cluster B personality disorders ('Dramatic, Emotional and Erratic'). They all have a clear structure and idea of how they work which must be explained to the patient. Longer-term therapy can last for years, and may have to be more than once a week. They all involve different ways of talking with a therapist, but are all different from each other. Some have a clear structure to them, others are more flexible. They include: Mentalisation - combines group and individual therapy. It aims to help you better understand yourself and others by being more aware of what s going on in your own head and in the minds of others. It is helpful in borderline personality disorder. Dialectical Behaviour Therapy this uses a combination of cognitive and behavioural therapies, with some techniques from Zen Buddhism. It involves individual therapy and group therapy, and has been claimed to significantly reduce self-harm in patients with borderline personality disorder Cognitive Therapy - a way to change unhelpful patterns of thinking. Schema Focused Therapy - a cognitive therapy that explores and changes collections of deep unhelpful beliefs. Again, it seems to be effective in borderline personality disorder. Transference Focused Therapy - a structured treatment in which the therapist explores and changes unconscious processes. It seems to be effective in borderline personality disorder. Dynamic Psychotherapy - looks at how past experiences affect present behaviour. It is similar to Transference Focused Therapy, but less structured. Cognitive Analytical Therapy - a way to recognize and change unhelpful patterns in relationships and behaviour Treatment in a therapeutic community this is a place where people with long-standing emotional problems can go to (or sometimes stay) for several weeks or months. Most of the work is done in groups. People learn from getting on or not getting on - with other people in the treatment group. It differs from 'real life' in that any disagreements or upsets happen in a safe place. People in treatment often have a lot of say over how the community runs. In the UK, it is more common now for this intensive treatment to be offered as a day programme, 5 days a week. 3. Social : support - Social Services Many people with personality disorder can lead full lives with support. This can be emotional - somebody to talk to - or practical - help with sorting bills out or arranging things. The support can be given by friends and families, self-help groups and networks, as well as your GP or mental health team. Support might be needed occasionally, when things get particularly difficult, or you regularly.

7 Family support and community network (day-based or residential therapeutic community) Admission to hospital usually happens only as a last resort (e.g. when a person with borderline personality disorder is harming themselves badly) and for a short time. A lot of help that was once only offered on hospital wards is now available in day centers and clinics. Complex Needs Service (CNS) for people with long-standing and hard to resolve emotional problems or interpersonal difficulties. A patient may be referred to the CNS by his/her psychiatrist, but in many cases (s)he may be encouraged to selfrefer by calling, writing to, or ing the CNS. After an initial meeting with the member of CNS, the patient may decide to join a weekly options group which aims to prepare him/her for joining a therapeutic community (TC). The patient may attend the options group for up to one year, during which time (s)he can decide whether or not to join TC. Joining a TC involves a commitment to attend a daily programme every weekday for a period of 18 months. This is a very significant commitment, and a demands a very high level of self-motivation. The idea behind a TC is that a patient is best able to change by interacting positively with other people, that is, by forming relationships with other people in an atmosphere of trust and security, and by feeling mutually accepted, valued, and supported. People who have spent time in a TC tend to use less medication and healthcare services than they used to, and also tend to require fewer hospital admissions. Indicators of admission: Crisis intervention Treatment of co-morbid disorders Stabilisation of existing medication regimen Reviewing the diagnosis and treatment plan Full risk assessment Admission : Involve cares, relatives, other agencies Care plan early on Focus on immediate needs Clear boundaries Support groups Early discharge

Mental Health Needs Assessment Personality Disorder Prevalence and models of care

Mental Health Needs Assessment Personality Disorder Prevalence and models of care Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual

More information

What is a personality disorder?

What is a personality disorder? What is a personality disorder? What is a personality disorder? Everyone has personality traits that characterise them. These are the usual ways that a person thinks and behaves, which make each of us

More information

Chapter 12 Personality Disorders

Chapter 12 Personality Disorders The Nature of Personality Disorders Chapter 12 Personality Disorders Enduring patterns of perceiving, relating to, and thinking about the world and oneself Manifest across many life areas Are inflexible

More information

Personality Disorders

Personality Disorders Personality Disorders Chapter 11 Personality Disorders: An Overview The Nature of Personality and Personality Disorders Enduring and relatively stable predispositions (i.e., ways of relating and thinking)

More information

Personality Disorders

Personality Disorders Abnormal Psychology PSYCH 40111 s s: An Overview The Nature of Personality and s A personality is all the ways we have of acting, thinking, believing, and feeling that make each of us unique and different

More information

Personality disorder. Caring for a person who has a. Case study. What is a personality disorder?

Personality disorder. Caring for a person who has a. Case study. What is a personality disorder? Caring for a person who has a Personality disorder Case study Kiara is a 23 year old woman who has been brought to the emergency department by her sister after taking an overdose of her antidepressant

More information

Working Definitions APPRECIATION OF THE ROLE OF EARLY TRAUMA IN SEVERE PERSONALITY DISORDERS

Working Definitions APPRECIATION OF THE ROLE OF EARLY TRAUMA IN SEVERE PERSONALITY DISORDERS Working Definitions PERSONALITY TRAIT a stable, recurring pattern of human behavior - e.g. a tendency to joke in serious situations, hypersensitivity to criticism, talkativeness in groups. PERSONALITY

More information

Personality Disorders

Personality Disorders Personality Disorders Source: Linda Lebelle, Focus Adolescent Services A Personality Disorder is identified by a pervasive pattern of experience and behaviour that is abnormal with respect to any of the

More information

Sue/Sue/Sue Understanding Abnormal Behavior, 9 th edition 2010 Cengage Learning CHAPTER EIGHT. Personality Disorders

Sue/Sue/Sue Understanding Abnormal Behavior, 9 th edition 2010 Cengage Learning CHAPTER EIGHT. Personality Disorders Sue/Sue/Sue Understanding Abnormal Behavior, 9 th edition 2010 Cengage Learning CHAPTER EIGHT Personality Disorders PERSONALITY DISORDERS Personality Disorder: Sue/Sue/Sue Understanding Abnormal Behavior,

More information

Personality Disorders

Personality Disorders Personality s The Good, the Bad and the Really, Really Ugly: Borderline and other Cluster B Personality s BY CHRIS OKIISHI, MD! Long standing! Often life long! Developmental origins! Genetic origins! Resistant

More information

[KQ 804] FEBRUARY 2007 Sub. Code: 9105

[KQ 804] FEBRUARY 2007 Sub. Code: 9105 [KQ 804] FEBRUARY 2007 Sub. Code: 9105 (Revised Regulations) Theory : Two hours and forty minutes Q.P. Code: 419105 Maximum : 100 marks Theory : 80 marks M.C.Q. : Twenty minutes M.C.Q. : 20 marks 1. A

More information

Personality Disorder:

Personality Disorder: Personality Disorder: An update for Primary Care Dr Pardeep Dhillon With inputs from Dr Chris Bench and Dr Neelima Reddi(Consultant Psychiatrists) Contents Diagnostic criteria Relation to Clustering Typical

More information

Unit 4: Personality, Psychological Disorders, and Treatment

Unit 4: Personality, Psychological Disorders, and Treatment Unit 4: Personality, Psychological Disorders, and Treatment Learning Objective 1 (pp. 131-132): Personality, The Trait Approach 1. How do psychologists generally view personality? 2. What is the focus

More information

Conceptual Models of Substance Use

Conceptual Models of Substance Use Conceptual Models of Substance Use Different causal factors emphasized Different interventions based on conceptual models 1 Developing a Conceptual Model What is the nature of the disorder? Why causes

More information

Borderline personality disorder

Borderline personality disorder Understanding NICE guidance Information for people who use NHS services Borderline personality disorder NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases

More information

Understanding 5 High Conflict Personality Disorders

Understanding 5 High Conflict Personality Disorders Understanding 5 High Conflict Personality Disorders Bill Eddy, LCSW, Esq. Attorney, Mediator, Therapist, Author Family Law Institute March 19, 2013 - Minneapolis Copyright 2013 High Conflict Institute

More information

Co-Occurring Disorders

Co-Occurring Disorders Co-Occurring Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Chapter 1: Introduction Early studies conducted in substance abuse programs typically

More information

Abnormal Psychology Practice Quiz #3

Abnormal Psychology Practice Quiz #3 Abnormal Psychology Practice Quiz #3 1. People with refuse to maintain a minimum, normal body weight, and have an intense fear of gaining weight. a. anorexia nirvana b. anorexia bulimia c. bulimia nervosa

More information

Symptoms of mania can include: 3

Symptoms of mania can include: 3 Bipolar Disorder This factsheet gives information on bipolar disorder. It explains the symptoms of bipolar disorder, treatments and ways to manage symptoms. It also covers what treatment the National Institute

More information

TREATING ASPD IN THE COMMUNITY: FURTHERING THE PD OFFENDER STRATEGY. Jessica Yakeley Portman Clinic Tavistock and Portman NHS Foundation Trust

TREATING ASPD IN THE COMMUNITY: FURTHERING THE PD OFFENDER STRATEGY. Jessica Yakeley Portman Clinic Tavistock and Portman NHS Foundation Trust TREATING ASPD IN THE COMMUNITY: FURTHERING THE PD OFFENDER STRATEGY Jessica Yakeley Portman Clinic Tavistock and Portman NHS Foundation Trust Treating the untreatable? Lack of evidence base for ASPD Only

More information

Borderline Personality Disorder and Treatment Options

Borderline Personality Disorder and Treatment Options Borderline Personality Disorder and Treatment Options MELISSA BUDZINSKI, LCSW VICE PRESIDENT, CLINICAL SERVICES 2014 Horizon Mental Health Management, LLC. All rights reserved. Objectives Define Borderline

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. Management of moderate to severe ere (including psychotic) depression in children and young people tiers 2 4 bring together all NICE guidance, quality standards and other NICE information on a specific

More information

Antisocial personality disorder

Antisocial personality disorder Understanding NICE guidance Information for people who use NHS services Antisocial personality disorder NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases

More information

SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES

SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES SPECIALIST ARTICLE A BRIEF GUIDE TO PSYCHOLOGICAL THERAPIES Psychological therapies are increasingly viewed as an important part of both mental and physical healthcare, and there is a growing demand for

More information

Personality Difficulties

Personality Difficulties Personality Difficulties The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. There

More information

Criteria to Identify Abnormal Behavior

Criteria to Identify Abnormal Behavior Criteria to Identify Abnormal Behavior Unusualness Social deviance Emotional distress Maladaptive behavior Dangerousness Faulty perceptions or interpretations of reality Hallucinations Delusions Copyright

More information

Washington State Regional Support Network (RSN)

Washington State Regional Support Network (RSN) Access to Care Standards 11/25/03 Eligibility Requirements for Authorization of Services for Medicaid Adults & Medicaid Older Adults Please note: The following standards reflect the most restrictive authorization

More information

Co-Occurring Disorders

Co-Occurring Disorders Co-Occurring Disorders PACCT 2011 CAROLYN FRANZEN Learning Objectives List common examples of mental health problems associated with substance abuse disorders Describe risk factors that contribute to the

More information

Borderline personality disorder

Borderline personality disorder Borderline personality disorder Treatment and management Issued: January 2009 NICE clinical guideline 78 guidance.nice.org.uk/cg78 NICE 2009 Contents Introduction... 3 Person-centred care... 5 Key priorities

More information

Co-Occurring Disorders

Co-Occurring Disorders Presented by Pamela Messore LICSW, LCDP Co-Occurring Disorder - formerly Dual Diagnosis - was once a challenge to providers. Historically, clients were treated in separate modalities - even separate agencies.

More information

Compiled by Julie Ann Romero AS 91 Spring 2010

Compiled by Julie Ann Romero AS 91 Spring 2010 Compiled by Julie Ann Romero AS 91 Spring 2010 Antisocial personality disorder is a psychiatric condition in which a person manipulates, exploits, or violates the rights of others. This behavior is often

More information

Antisocial personality disorder

Antisocial personality disorder Page 1 of 7 Diseases and Conditions Antisocial personality disorder By Mayo Clinic Staff Antisocial personality disorder is a type of chronic mental condition in which a person's ways of thinking, perceiving

More information

Schizoaffective Disorder

Schizoaffective Disorder FACT SHEET 10 What Is? Schizoaffective disorder is a psychiatric disorder that affects about 0.5 percent of the population (one person in every two hundred). Similar to schizophrenia, this disorder is

More information

Personality Disorders

Personality Disorders Abnormal Psychology Clinical Perspectives on Psychological Disorders 5e Personality Disorders Chapter 10 Personality Disorders Chapter 10 Personality trait An enduring pattern of perceiving, relating to,

More information

The Priory Group. What is obsessive-compulsive disorder?

The Priory Group. What is obsessive-compulsive disorder? The Priory Group What is obsessive-compulsive disorder? by Dr David Veale Dr Veale is a Consultant Psychiatrist at the Priory Hospital North London and the coauthor of Overcoming Obsessive Compulsive Disorder

More information

Planning Services for Persons with Developmental Disabilities and Mental Health Diagnoses

Planning Services for Persons with Developmental Disabilities and Mental Health Diagnoses Planning Services for Persons with Developmental Disabilities and Mental Health Diagnoses Persons with Intellectual Disabilities (ID) have mental disorders three to four times more frequently than do persons

More information

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

Obsessive-Compulsive Disorder and Body Dysmorphic Disorder South West London and St George s Mental Health NHS Trust A National Service for Obsessive-Compulsive Disorder and Body Dysmorphic Disorder Springfield University Hospital A Referrer s Guide 1 Who we are

More information

Let s talk about Eating Disorders

Let s talk about Eating Disorders Let s talk about Eating Disorders Dr. Jane McKay Dr. Ric Arseneau Dr. Debbie Rosenbaum Dr. Samantha Kelleher Dr. Julia Raudzus Role of the Psychiatrist Assessment and diagnosis of patients with eating

More information

Clinical features - Depression

Clinical features - Depression Mood CRS Formulation Depression The word depression is used to describe a variety of states ranging from normal unhappiness after a loss up to severe major depressive illness with physical and psychotic

More information

What works for bipolar disorder and how should this be delivered in practice?

What works for bipolar disorder and how should this be delivered in practice? What works for bipolar disorder and how should this be delivered in practice? Daniel Smith daniel.smith@glasgow.ac.uk W4 Improving the diagnosis and management of bipolar disorder: screening, integrated

More information

Abnormal Psychology PSY-350-TE

Abnormal Psychology PSY-350-TE Abnormal Psychology PSY-350-TE This TECEP tests the material usually taught in a one-semester course in abnormal psychology. It focuses on the causes of abnormality, the different forms of abnormal behavior,

More information

WORKERS COMPENSATION PROTOCOLS WHEN PRIMARY INJURY IS PSYCHIATRIC/PSYCHOLOGICAL

WORKERS COMPENSATION PROTOCOLS WHEN PRIMARY INJURY IS PSYCHIATRIC/PSYCHOLOGICAL WORKERS COMPENSATION PROTOCOLS WHEN PRIMARY INJURY IS PSYCHIATRIC/PSYCHOLOGICAL General Guidelines for Treatment of Compensable Injuries Patient must have a diagnosed mental illness as defined by DSM-5

More information

Personality Disorders: Recognition, Diagnosis, Treatment & Survival Chatman Neely

Personality Disorders: Recognition, Diagnosis, Treatment & Survival Chatman Neely Personality Disorders: Recognition, Diagnosis, Treatment & Survival Chatman Neely Welcome Phase One: Recognition Chronic and Persistent Pattern of relating to self and others: look for suffering!!! Characteristics

More information

THERASCRIBE INFORMATION

THERASCRIBE INFORMATION THERASCRIBE INFORMATION TheraScribe is a professional counseling software program, designed by therapists to assist in the dayto-day recordkeeping and paperwork necessary to operate a private practice,

More information

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS

BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS BRIEF NOTES ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems

More information

Anti-Social Personality Disorder

Anti-Social Personality Disorder Anti-Social Personality Disorder Definition Anti-Social Personality Disorder is a type of chronic mental condition in which a person's ways of thinking, perceiving situations and relating to others are

More information

Postnatal depression is an illness. It is not a sign that you don't love your baby or can't look after your baby properly.

Postnatal depression is an illness. It is not a sign that you don't love your baby or can't look after your baby properly. Patient information from the BMJ Group Postnatal depression Postnatal depression is an illness that women can get after having a baby. If you have it, you may feel sad and anxious, and find it hard to

More information

Psychiatric morbidity among prisoners:

Psychiatric morbidity among prisoners: Psychiatric morbidity among prisoners: Summary report Nicola Singleton Howard Meltzer Rebecca Gatward with Jeremy Coid Derek Deasy A survey carried out in 1997 by the Social Survey Division of ONS on behalf

More information

From damage to disorder; working with personality difficulties in a forensic setting Julia Harrison Occupational Therapist - Adult Forensic Services

From damage to disorder; working with personality difficulties in a forensic setting Julia Harrison Occupational Therapist - Adult Forensic Services From damage to disorder; working with personality difficulties in a forensic setting Julia Harrison Occupational Therapist - Adult Forensic Services Northumberland, Tyne and Wear NHS Foundation Trust From

More information

Post-traumatic stress disorder overview

Post-traumatic stress disorder overview Post-traumatic stress disorder overview A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

Depression in Older Persons

Depression in Older Persons Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression

More information

Assessment of depression in adults in primary care

Assessment of depression in adults in primary care Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and

More information

Sue R. (Chartered Clinical & Forensic Psychologist) B.Sc. (Hons.), M.Sc., D. Clin. Psychol. AFBPSs.

Sue R. (Chartered Clinical & Forensic Psychologist) B.Sc. (Hons.), M.Sc., D. Clin. Psychol. AFBPSs. Sue R (Chartered Clinical & Forensic Psychologist) B.Sc. (Hons.), M.Sc., D. Clin. Psychol. AFBPSs. PROFESSIONAL QUALIFICATIONS & EXPERTISE Professional Qualification British Psychological Society Chartered

More information

Borderline personality disorder

Borderline personality disorder Issue date: January 2009 Borderline personality disorder Borderline personality disorder: treatment and management NICE clinical guideline 78 Developed by the National Collaborating Centre for Mental Health

More information

Traumatic Stress. and Substance Use Problems

Traumatic Stress. and Substance Use Problems Traumatic Stress and Substance Use Problems The relation between substance use and trauma Research demonstrates a strong link between exposure to traumatic events and substance use problems. Many people

More information

Borderline Personality Disorder

Borderline Personality Disorder Borderline Personality Disorder Borderline Personality Disorder Formerly called latent schizophrenia Added to DSM III (1980) as BPD most commonly diagnosed in females (75%) 70-75% have a history of at

More information

Psychology Externship Program

Psychology Externship Program Psychology Externship Program The Washington VA Medical Center (VAMC) is a state-of-the-art facility located in Washington, D.C., N.W., and is accredited by the Joint Commission on the Accreditation of

More information

Diagnosis and Assessment of Personality Disorders

Diagnosis and Assessment of Personality Disorders Diagnosis and Assessment of Personality Disorders Michael B. First, M.D. Editor, DSM-IV Text and Criteria Department of Psychiatry, Columbia University What is a Personality Disorder? an enduring pattern

More information

ANTISOCIAL PERSONALITY DISORDER: IS IT TREATABLE? JESSICA YAKELEY PORTMAN CLINIC TAVISTOCK AND PORTMAN NHS FOUNDATION TRUST

ANTISOCIAL PERSONALITY DISORDER: IS IT TREATABLE? JESSICA YAKELEY PORTMAN CLINIC TAVISTOCK AND PORTMAN NHS FOUNDATION TRUST ANTISOCIAL PERSONALITY DISORDER: IS IT TREATABLE? JESSICA YAKELEY PORTMAN CLINIC TAVISTOCK AND PORTMAN NHS FOUNDATION TRUST ANTISOCIAL PERSONALITY DISORDER: IS IT TREATABLE? Why care about ASPD? Why care

More information

Dr Steve Moss BSc MSc Phd, Consultant Research Psychologist attached to the Estia Centre, Guys Hospital, London.

Dr Steve Moss BSc MSc Phd, Consultant Research Psychologist attached to the Estia Centre, Guys Hospital, London. INFORMATION SHEET Mental health problems in people with learning disabilities Dr Steve Moss BSc MSc Phd, Consultant Research Psychologist attached to the Estia Centre, Guys Hospital, London. In the whole

More information

CRITERIA CHECKLIST. Serious Mental Illness (SMI)

CRITERIA CHECKLIST. Serious Mental Illness (SMI) Serious Mental Illness (SMI) SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the diagnoses. Adults must meet all of the following five criteria:

More information

AP PSYCHOLOGY CASE STUDY

AP PSYCHOLOGY CASE STUDY Mr. Pustay AP PSYCHOLOGY AP PSYCHOLOGY CASE STUDY OVERVIEW: We will do only one RESEARCH activity this academic year. You may turn in the CASE STUDY early (no earlier than MID-TERM date). It will be due

More information

ANTISOCIAL PERSONALITY DISORDER

ANTISOCIAL PERSONALITY DISORDER ANTISOCIAL PERSONALITY DISORDER Antisocial personality disorder is a type of chronic mental illness in which your ways of thinking, perceiving situations and relating to others are dysfunctional. When

More information

Client Information Leaflet

Client Information Leaflet The Dialectical Behaviour Therapy Endeavour Programme Creating a life worth living Client Information Leaflet HSE South - North Lee Adult Mental Health Service Dialectical Behaviour Therapy Programme July

More information

Table of Contents. Preface...xv. Part I: Introduction to Mental Health Disorders and Depression

Table of Contents. Preface...xv. Part I: Introduction to Mental Health Disorders and Depression Table of Contents Visit www.healthreferenceseries.com to view A Contents Guide to the Health Reference Series, a listing of more than 16,000 topics and the volumes in which they are covered. Preface...xv

More information

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD cnuckols@elitecorp1.com Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes

More information

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1 What is bipolar disorder? There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated

More information

Overview of DSM-5. With a Focus on Adult Disorders. Gordon Clark, MD

Overview of DSM-5. With a Focus on Adult Disorders. Gordon Clark, MD Overview of DSM-5 With a Focus on Adult Disorders Gordon Clark, MD Sources include: 1. DSM-5: An Update D Kupfer & D Regier, ACP Annual Meeting, 2/21-22/13, Kauai 2. Master Course, DSM-5: What You Need

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. Using antidepressants in children and young people bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They

More information

D. Clinical indicators for psychiatric evaluation are established by one or more of the following criteria. The consumer is:

D. Clinical indicators for psychiatric evaluation are established by one or more of the following criteria. The consumer is: MCCMH MCO Policy 2-015 Date: 4/21/11 V. Standards A. A psychiatric evaluation shall be done as an integral part of the assessment process. It serves as the guide to the identification of medical and psychiatric

More information

MENTAL IMPAIRMENT RATING

MENTAL IMPAIRMENT RATING MENTAL IMPAIRMENT RATING Lev.II Curriculum Rev. 6/09 155 OBJECTIVES MENTAL AND BEHAVIORAL DISORDERS 1. Identify the axes used in the diagnostic and statistical manual of mental disorders - DSM. 2. Understand

More information

Borderline. Personality

Borderline. Personality A Guide to Accessing Ser vices for Borderline Personality Disorder in Victoria ABOUT THIS GUIDE: WHAT IS Borderline Personality Disorder (BPD)? This guide refers to the National Health and Medical Research

More information

Definition of Terms. nn Mental Illness Facts and Statistics

Definition of Terms. nn Mental Illness Facts and Statistics nn Mental Illness Facts and Statistics This section contains a brief overview of facts and statistics about mental illness in Australia as well as information that may be useful in countering common myths.

More information

Step 4: Complex and severe depression in adults

Step 4: Complex and severe depression in adults Step 4: Complex and severe depression in adults A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

POLL. Co-occurring Disorders: the chicken or the egg. Objectives

POLL. Co-occurring Disorders: the chicken or the egg. Objectives Co-occurring Disorders: the chicken or the egg Christopher W. Shea, MA, CRAT, CAC-AD Clinical Director Father Martin s Ashley Havre de Grace, Maryland chrismd104@yahoo.com Objectives To identify what is

More information

Problem Gambling. Your Guide to Understanding. www.hpb.gov.sg 1800 223 1313

Problem Gambling. Your Guide to Understanding. www.hpb.gov.sg 1800 223 1313 Problem Gambling Your Guide to Understanding www.hpb.gov.sg 1800 223 1313 CONTENTS 04 05 06 07 08 How common is problem What are the signs of problem Who can be affected by problem How is problem gambling

More information

Homelessness and mental health in a northern English Steel City (Sheffield)

Homelessness and mental health in a northern English Steel City (Sheffield) Homelessness and mental health in a northern English Steel City (Sheffield) Integrated Services and Housing: OECD Conference Centre, Paris 8 th and 9 th November, 2012 Professor Tim Kendall Director of

More information

Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78

Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78 Borderline personality disorder: recognition and management Clinical guideline Published: 28 January 2009 nice.org.uk/guidance/cg78 NICE 2009. All rights reserved. Your responsibility The recommendations

More information

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm E-Resource March, 2014 POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm Post-traumatic Stress Disorder

More information

Detention under the Mental Health Act

Detention under the Mental Health Act Detention under the Mental Health Act This factsheet gives information about detention under the Mental Health Act. This is also known as being sectioned. It explains what the Mental Health Act is, why

More information

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) Post-Traumatic Stress Disorder (PTSD) Post traumatic stress disorder is a condition where you have recurring distressing memories, flashbacks, and other symptoms after suffering a traumatic event. Treatment

More information

PSYCHIATRIC EMERGENCY. Department of Psychiatry Pomeranian Medical University in Szczecin

PSYCHIATRIC EMERGENCY. Department of Psychiatry Pomeranian Medical University in Szczecin PSYCHIATRIC EMERGENCY Department of Psychiatry Pomeranian Medical University in Szczecin Sudden psychic disturbances including: - cognition - thought process - emotional area - psychomotor activity when

More information

Breaking the cycles of Borderline Personality Disorder

Breaking the cycles of Borderline Personality Disorder Breaking the cycles of Borderline Personality Disorder Borderline Personality Disorder (BPD) is a complex and difficult to treat condition affecting up to 2 % of the UK s adult population, and 50 % of

More information

Seniors and. Depression. What You Need to Know. Behavioral Healthcare Options, Inc.

Seniors and. Depression. What You Need to Know. Behavioral Healthcare Options, Inc. Seniors and Depression What You Need to Know Behavioral Healthcare Options, Inc. Depression More Than Just The Blues ou may not know exactly what is wrong with you, but you do know that you just don t

More information

Emergency in the Psychiatric

Emergency in the Psychiatric Emergency in the Psychiatric Care and its Legal Regulation Márta Farkas - Zoltán Hidasii Psychiatric Emergency I. Any disturbance in toughts, feelings or actions for wich immediate therapeutic intervention

More information

GENDER SENSITIVE REHABILITATION SERVICES FOR WOMEN A workshop

GENDER SENSITIVE REHABILITATION SERVICES FOR WOMEN A workshop GENDER SENSITIVE REHABILITATION SERVICES FOR WOMEN A workshop Theresa Tatton Consultant Psychiatrist Women s Medium Secure Service Fromeside Bristol Shawn Mitchell Consultant Psychiatrist Women s Service

More information

UNDERSTANDING CO-OCCURRING DISORDERS. Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015

UNDERSTANDING CO-OCCURRING DISORDERS. Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015 UNDERSTANDING CO-OCCURRING DISORDERS Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015 CO-OCCURRING DISORDERS What does it really mean CO-OCCURRING

More information

ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com

ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com Borderline Personality Disorder: The Latest Assessment and Treatment Strategies Questions from chapter 1 1) The first written work on BPD described these clients as occupying a continuum between a) neurosis

More information

The Field of Counseling. Veterans Administration one of the most honorable places to practice counseling is with the

The Field of Counseling. Veterans Administration one of the most honorable places to practice counseling is with the Gainful Employment Information The Field of Counseling Job Outlook Veterans Administration one of the most honorable places to practice counseling is with the VA. Over recent years, the Veteran s Administration

More information

THE NEUROBIOLOGY OF PERSONALITY DISORDERS

THE NEUROBIOLOGY OF PERSONALITY DISORDERS THE NEUROBIOLOGY OF PERSONALITY DISORDERS Overview Neurologists and primary care doctors manage patients with a wide range of psychiatric disturbances to include personality disorders. The definition of

More information

Medical Necessity Criteria

Medical Necessity Criteria Medical Necessity Criteria 2015 Updated 03/04/2015 Appendix B Medical Necessity Criteria Purpose: In order to promote consistent utilization management decisions, all utilization and care management staff

More information

Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us

Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us Mental Health Disorders An estimated 57.7 million adults (26.2% of adult population) suffer

More information

Step 2: Recognised depression in adults persistent subthreshold depressive symptoms or mild to moderate depression

Step 2: Recognised depression in adults persistent subthreshold depressive symptoms or mild to moderate depression Step 2: Recognised depression in adults persistent subthreshold depressive symptoms or mild to moderate depression A NICE pathway brings together all NICE guidance, quality standards and materials to support

More information

Psychotic Disorders. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com mhff0101 Last reviewed: 01/10/2013 1

Psychotic Disorders. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com mhff0101 Last reviewed: 01/10/2013 1 Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people

More information

CBT for personality disorders with men. Professor Kate Davidson NHS Greater Glasgow and Clyde, Scotland

CBT for personality disorders with men. Professor Kate Davidson NHS Greater Glasgow and Clyde, Scotland CBT for personality disorders with men with ASPD and psychopathy Professor Kate Davidson NHS Greater Glasgow and Clyde, Scotland Can we treat Antisocial Personality Disorder? 11 trials in total 8 trials

More information

Dual diagnosis: working together

Dual diagnosis: working together Dual diagnosis: working together Tom Carnwath RCGP conference Birmingham 2007 DSM-IV & cocaine Cocaine intoxication Cocaine withdrawal Cocaine-induced sleep disorder Cocaine-induced sexual dysfunction

More information

Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families

Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families Presented By Dr. Pamela Gillen University of Colorado Anschutz Medical Campus and Dan

More information

Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder

Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder Clinical Practice Guidelines: Attention Deficit/Hyperactivity Disorder AACAP Official Action: OUTLINE OF PRACTICE PARAMETERS FOR THE ASSESSMENT AND TREATMENT OF CHILDREN, ADOLESCENTS, AND ADULTS WITH ADHD

More information

Suicide Assessment in the Elderly Geriatric Psychiatric for the Primary Care Provider 2008

Suicide Assessment in the Elderly Geriatric Psychiatric for the Primary Care Provider 2008 Suicide Assessment in the Elderly Geriatric Psychiatric for the Primary Care Provider 2008 Lisa M. Brown, Ph.D. Aging and Mental Health Louis de la Parte Florida Mental Health Institute University of South

More information

A 10-year follow-up study of drug users in treatment. Grethe Lauritzen, SIRUS

A 10-year follow-up study of drug users in treatment. Grethe Lauritzen, SIRUS A 10-year follow-up study of drug users in treatment Grethe Lauritzen, SIRUS A prospective co-hort study 10-year observation period (1998-2009) 481 clients interviewed in 20 treatment facilities in and

More information