Topics:

1. GENERAL PERSONALITY DISORDER

2. PERSONALITY CHANGE DUE TO OTHER
MEDICAL CONDITION
3. OTHER SPECIFIED PERSONALITY
DISORDER
4. UNSPECIFIED PERSONALITY DISORDER
5. OBSESSIVE COMPULSIVE PERSONALITY
DISORDER
1.General personality disorder
DSM-5 criteria General Personality Disorder:

A.) An enduring pattern of inner experience and behaviour that deviates markedly from the
expectations of the individual’s culture. This pattern is manifested in two (or more) of
the following areas:

1. Cognition (i.e., ways of perceiving and interpreting self, other people, and events).
2. Affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response).
3. Interpersonal functioning (interaction with people is affected)
4. Impulse control. (inability to control emotions and behaviour)

B.) The enduring pattern is inflexible and pervasive across a broad range of personal and
social situations.
DSM-5 criteria for General Personality Disorder:

C.) The enduring pattern leads to clinically significant distress or impairment in social, occupational, or
other important areas of functioning.

D.) The pattern is stable and of long duration, and Its onset can be traced back at least to adolescence or
early adulthood (no later than early adulthood).

Note:
-Personality Disorders can be exacerbated by stressful events (loss of spouse, job). Do not confuse with post-traumatic
stress disorder!

-People with personality disorder often presents late. (People think that: I’m ‘okay’)

-Personality change that appears in middle adulthood or later life (consider other medical cause or substance use)
DSM-5 criteria for General Personality Disorder:

E.) The enduring pattern is not better explained as a manifestation or consequence of another mental
disorder.

F.) The enduring pattern is not attributable to the physiological effects of a substance (e.g.,
a drug of abuse, a medication) or another medical condition (e.g., head trauma).
Differential diagnosis of personality disorder:
1.) Psychotic disorders (Schizophrenia, Schizoid and Schizotypal disorder)
2.) Anxiety and depressive disorder
3.) Post-traumatic stress disorder
4.) Substance use disorder
5.) Personality change due to another medical condition
2. Personality change due to another medical
condition
DSM-5 criteria:

A. ) A persistent personality disturbance that represents a change from the

individual’s previous characteristic personality pattern.

B.) There is evidence from the history, physical examination, or laboratory findings
that the disturbance is the direct pathophysiological consequence of another medical
condition. (stroke, brain tumour)
DSM-5 criteria:

C.) not better explained by another mental disorder.

D.) does not occur exclusively during the course of a delirium.

E.) causes significant distress or impairment in social, occupational or other

important areas of functioning.
 
Subtypes of personality change due to another medical condition:
Subtypes Characteristics
Labile type Mood Lability

Disinhibited type Poor impulse control

Aggressive type Aggressive behaviour

Apathetic type Apathy and Indifference

Paranoid type Suspicious or paranoid ideation

Other type Not characterized by any of the above subtype

Combined type More than one feature is present

Unspecified type -
List of neurological and other medical conditions that may cause
personality change:
1. Central nervous system neoplasms
2. Head trauma
3. Cerebrovascular disease
4. Huntington's disease
5. Epilepsy
6. HIV infection (CNS involvement)
7. Endocrine condition (hypothyroidism)
8. Systemic lupus erythematosus (CNS involvement)
Differential diagnosis:
1. Delirium
2. Another mental disorder due to another medical condition
(e.g, depressive disorder due to brain tumour)
3. Substance use disorders
4. Other mental disorder (Schizophrenia, Mood disorders, Panic disorders)
5. Other personality disorders
3. Other specified personality disorder
-Characteristics of a personality disorder that cause clinically significant distress or
impairment in social, occupational, or other important areas of functioning BUT do
not meet the full criteria for any of the disorders in the personality disorders
diagnostic class.

-It is used when clinician chooses to communicate the specific reason for a
personality disorder.

E.g: “Other specified personality disorder” – Mixed personality features”

4.Unspecified personality disorder
-Characteristics of a personality disorder that cause clinically significant distress or
impairment in social, occupational, or other important areas of functioning BUT do
not meet the full criteria for any of the disorders in the personality disorders
diagnostic class.

-It is used in situations in which clinician chooses not to specify the reason for a
personality disorder.

-E.g: insufficient information to make a more specific diagnosis

5. Obsessive-Compulsive Personality Disorder
(OCPD)
Obsessive-Compulsive Personality
Disorder (OCPD)
 A pervasive pattern of preoccupation with orderliness, perfectionism, and mental
and interpersonal control, at the expense of flexibility, openness, and efficiency,
beginning by early adulthood and present in a variety of contexts, as indicated by
four (or more) of the following:

 1. Is preoccupied with details, rules, lists, order, organization, or schedules to the

extent that the major point of the activity is lost.
 2. Shows perfectionism that interferes with task completion (e.g., is unable to
complete a project because his or her own overly strict standards are not met).
 3. Is excessively devoted to work and productivity to the
exclusion of leisure activities and friendships (not accounted
for by obvious economic necessity).
 4. Is overconscientious, scrupulous, and inflexible about
matters of morality, ethics, or values (not accounted for by
cultural or religious identification).
 5. Is unable to discard worn-out or worthless objects even
when they have no sentimental value.
 6. Is reluctant to delegate tasks or to work with others unless they
submit to exactly his or her way of doing things.
 7. Adopts a miserly spending style toward both self and others;
money is viewed as something to be hoarded for future catastrophes.
 8. Shows rigidity and stubbornness.
Sheldon Cooper