RISK FACTORS: Positive family history, Pregnancy risk factors, Nutritional deprivation, Use of alcohol or drugs, Viral and bacterial Infections, Dysfunctional family with child abuse and neglect
GENERAL MEASURES
• Long term psychotherapy and cognitive behavior therapy
• Group therapy is helpful in the utilization of therapeutic confrontation and increasing one’s awareness and
insight regarding the damaging effects of dysfunctional behavior patterns
ACTIVITY Regular physical exercise helps in coping with stress and the activities of daily living
DIET Emphasize variety of healthy foods, avoid obesity
PATIENT EDUCATION Bibliotherapy and writing therapy, specific assignments and watching certain movies to better understand the nature and origin of one’s specific condition are helpful
• The movie “As Good As It Gets” illustrates someone with obsessive compulsive behaviors and their impact
on activities of daily living and relationships with family and friends
• The movie series The Godfather is an example of several characters with anti-social personality disorder
and how this affects their interpersonal relationships and their own physical and mental health
DRUG(S) OF CHOICE
. No specific drugs treat personality disorders, however, specific medications can reduce the intensity,
frequency, and dysfunctionality of certain behaviors, thoughts, and feelings
. Symptom management:
. Mini-psychosis (associated with paranoid, schizoid, and schizotypal personality disorders). Atypical
antipsychotics: clozapine (Clozaril), risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa),
ziprasidone (Geodon), and aripiprazole (Abilify). Start with a low dose gradually adjusting to the patients
needs.
. Anxiety. Anxiolytics: benzodiazepines, buspirone, and the SSRIs
. Depressed mood. Anti-depressants: SSRIs
. Many patients with borderline personality disorder respond well to small doses of atypical neuroleptics and mood stabilizers
ALTERNATIVE DRUGS Mood stabilizers (e.g., lithium carbonate, divalproex [Depakote] and anti-epileptic drugs may be helpful )
PATIENT MONITORING
• If substance abuse is suspected, check drug screens
• Infrequent sessions, with relative or friends, helpful in monitoring progress and behavior changes
POSSIBLE COMPLICATIONS
• Disruptive family life with frequent divorces and separations, alcoholism, substance abuse and drug addiction
• Disruptive behaviors in the work place may cause absenteeism, loss of productivity, and loss of self support
• Violation of the law and disregard for the concerns and rights of others
EXPECTED COURSE/PROGNOSIS
Personality disorders are enduring patterns of behavior throughout one’s lifetime and are not easily responsive
to treatment